[Previous Months][Date Index][Thread Index][Join - Register][Login]
[Message Prev][Message Next][Thread Prev][Thread Next]

Re: [IP] Insurance policy----How to get!

OK.  Before we all get on the kick about the evil insurance companies
plotting against the diabetics...everybody sometimes get frustrated at the
red tape...life is full of red tape.  You just have to learn to navigate it.
And it is true that the employer does pick what will be covered and what will
not be.  It may be that although the states has mandated coverage, the
companies are always given a date to start the coverage (usually 1-2
years...when I was in Indiana that is how much longer I had to wait AFTER the
law was passed.)

Janice...ask for the SUMMARY PLAN DESCRIPTION.  It is a federal requirement
that all employees have a copy or have access to one.  Double check you
information that you have as for all you know, you may already have a copy.
I have always received one every year.

Then, call the insurance company again and ask them if the test strips are
covered under DURABLE MEDICAL EQUIPMENT.  Some places consider them a
prescription while others consider them DME.  My policy will be changing
starting the first of the year to cover them as DME now they are a
prescription.)  So it may just be how they classify the strips.  However, I
have found that one policy that I had did not volunteer that the strips were
(years ago) covered as DME.  They would just tell me that they weren't
covered under the prescription benefit.

If you take you time (I know it has been a lot of time already) and ask the
right questions, you will make progress.  If none of the above works, contact
your State Bureau of Insurance (Or whatever it is called...all states have
them,) and see what they say.  Once this branch is involved, you get pretty
darn quick responses, and positive responses, from the insurance company.

And before I get flamed, I do not work for an insurance company.  But I have
learned that you get more flies with honey than you do with vinegar.  My
mother has provided me with MUCH assistance in the insurance matters as she
is the agent in the family.

Roxanne M. Villanueva RD, LD, CPT
Registered and Licensed Dietitian
Minimed Certified Insulin Pump Trainer
IDDM X >19 Years, Pumping 1/4/1995
(First with Disetronic and now with MM since 11/00 and am much happier!)
"Diabetes is a disease of complications waiting to happen." - - - Mary Tyler

In a message dated 11/6/2001 04:17:40 PM Eastern Standard Time,
email @ redacted writes:

> My husband works for one of the major oil companies. We have been trying to
> get a copy of his policy on health insurance since June. The main person
> over
> the insurance said that they can't do that. Of course in their 2" thick
> book
> on insurance it only gives vague terms concerning test strips. The
> mail-order
> drug company doesn't cover the strips because it is not in Shell's
> insurance
> policy to cover them. Of course we want to see it in writing which we can't
> get a copy of. By the way we live in a state that mandates that the
> diabetic
> supplies have to be covered. How can you go about making the company give
> you
> a copy of the policy? I have used all of the surplus of strips that I have.
for HELP or to subscribe/unsubscribe, contact: HELP@insulin-pumpers.org
send a DONATION http://www.Insulin-Pumpers.org/donate.shtml