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RE: [IP] insurance quandry (groan)

Although I'll be starting my pump this Tuesday, I asked my small hometown
pharmacy about the supplies.  He said he could order them from either MM or
another supplier and have them for me in a few days if needed.  Don't deal
with any big pharmacy like Walgreen's or something, they are bound by
suppliers. A good local owned pharmacy may be your best bet.
Reply-To: <email @ redacted>
From: "Trish Suchy" <email @ redacted>
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Subject: [IP] insurance quandry (groan)
Date: Thu, 28 Nov 2002 08:31:39 -0600
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Hi folks.  Does anyone else here live in Louisiana & have the state
employees' health plan that changed last summer to be administrated by Blue
Cross?  Or maybe a similar situation?

I just found out that we have a plan that will not let MiniMed (from whom I
have purchased my pump supplies for over 3 years) file my insurance claims
thru their local Blue Cross.  I gather this is a cheaper deal for my
insurance folks, although I am, of course, paying more for the insurance
than I was before it changed.  I had no choice but to change, BTW.  Mind you
it took talking to a zillion people at MiniMed & BC to get that info.  Ergo
my insurance is now treating MM as if it is not part of their PPO, and will
only pick up 30% of the tab for supplies after deductible.  I can't afford
this without considerable sacrifice.  I'm a teacher, and they don't pay us
too well down here.

When asked *where* I can purchase pump supplies "in-network" for my plan,
the insurance office can only give me a list of "durable medical supply"
places.  I began calling those, & many of them are out of business or have
never heard of the pump & never carried supplies like that.  Just standard
stuff like bedpans & walkers.  It was a useless list.

Sooooo in a marathon of calling and being shuffled about I asked many people
at MiniMed:  who in my area retails your supplies?  This seems like a simple
enough question.  For mysterious reasons, they can't or won't share this
information with me.  The furthest I got was a customer service rep who gave
me the name of hospitals in my area.  I tried calling the hospital
pharmacies & quickly determined that it's not the outpatient pharmacies but
the inpatient ones, through educator programs, and these supplies are just
to get people started on pumps, and they don't do retail to outpatients.

I called the 2 diabetes educator programs in town (Baton Rouge).  One was
appalled, said this insurance deal was new to them, of concern since many of
their patient have the same plan, & they had no idea where to purchase
besides from MiniMed.  The other said the same, although one of them is
working to see if we can get supplies from some connection she has in New
Orleans.  All very tentative & not very reassuring.

I do intend to file an insurance grievance and rattle the cages & bang the
bars over this, but these things take time.  Meanwhile I'm wondering--I
can't be the only pump-wearer on the cut-rate form of BC.  What do any of
you do?  Suck it in and pay through the nose?  Do you have any cheaper
resources?  I will look at the website, but I think I need a local supplier,
& I can't find one.  There may not *be* one.

Does anyone know where I can purchase supplies?  Where do you get yours,
fellow pumpers?  How can I find "in-network" suppliers if my insurance
company can't provide any help--nor can MiniMed?

I have a 507c.  Next year I get a new pump, & I'd like to work with a
company that will/can work with my insurance, naturally.

Thanks, and sorry for the long boring story.  Happy Thanksgiving.
email @ redacted
(Dx 1970, pumping 3.5 years, and I ain't down yet)
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for HELP or to subscribe/unsubscribe, contact: HELP@insulin-pumpers.org
send a DONATION http://www.Insulin-Pumpers.org/donate.shtml