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Re: [IP] New Insurance, New Pump

On 11/4/02 4:17 PM, "jhughey" <email @ redacted> wrote:

>> insurance companies are not aware of what
>> the previous companies have covered, so as long as you get a Letter of
>> Medical Necessity from your doctor it will be covered.
> George,
> Would you please explain some more? If the new ins. co. doesn't know about
> the previous pump purchase(s), how do you convince them you need a
> replacement? If that's what you are saying, how does the new co. know you
> need a pump - period? Wouldn't it mean going through proof of necessity all
> over again to convince them? I was thinking of doing this but I see our ins.
> will pay 100% *UP TO* $2,000.00 - bummer!!!!!
>  Jan (63 y/o, T-1 11/5/50, pmpg 8/23/83) & Bluda Sue (MM507C 3/99)

Jan, the point is you won't have your new company saying "no you can't get a
new pump, you got one three months ago from your prior Ins. Co."    ;>P
It can be approached as getting a replacement pump, but it is probably just
easier acting as though it was the first pump you've gotten.  If there are
difficulties you could then argue the point that you have been on the pump
for a number of years and would not be able to maintain an A1c in a
reasonable range without a replacement to your "defective pump".   You
Certainly wouldn't allow them to come out and do a technical inspection on
your current pump, and I wouldn't think they would broach the subject.  But
I suppose if you had some real Snidely Whiplash agent they could cause you
trouble going back to the same pump company.

The trouble you have with your coverage is the pump company  is going to
offer a discount to offset part of your co-pay if you return your current
pump.  That is the point where Snidely can stick his evil nose into the
deal.  Get everything in writing from all sides before you sign on the
dotted line.      :>)

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