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RE: [IP] Re: insurance quandry

I've been told by MiniMed that 50% of their insurance business is through
United Health Care.  They just got my pump and supplies approved for
shipping in 3 days. UHC is the way to go
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Subject: [IP] Re: insurance quandry 
Date: Thu, 28 Nov 2002 23:00:03 -0600
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Trish Suchy <email @ redacted wrote:
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.

Trish - I switched to HMO Illinois, a BC/BS affiliate 2 years ago.  The
time I called Minimed and they got approval from my insurance and everything
was fine.  The second time, the policy had changed and I had to go through a
durable supply company (Ultracare) and somehow I ended up with supplies from
both!  It was a mess and HMO Illinois told me to send one box back. From
on I had to use Ultracare because it was the company that my medical group
an agreement with.  Can you ask your doctors office how they handle medical
supplies for your insurance?  I would think they should know who to go
through.  I really preffered going through Minimed because they knew what I
was talking about.  Ultracare didn't know anything about pumps (the person
taking my order asked me if I was an insulin dependent diabetic!) and they
sent me the wrong infusion sets (later they sent them to me again in
to the corrrect ones and tried to bill HMO Ill for it but I returned them
let HMO Ill know what happened).  They also charged twice what MInimed
and I also let HMO Ill know that but they said that it was more convenient
them to do it this way and they might save on some other supplies.

Anyway, my understanding was that the medical group is suppose to control
referrals.  If one of those durable medical supply companies are in-network
then maybe they will have to order insulin pump supplies for you whether
currently do or not.  I have found that I need to give them the specific
Minmed number and then check when you get it to make sure it is correct.
my plan (in Illinois) all my pump supplies were covered at 100%.  They also
covered testing strips, lancets, syringes, disposable insulin pens, and
glycagon at 100%.  With mine and my daughters supplies I am only paying for
insulin in vials! I am switching back to United Health Care for various
reasons but mostly because HMO Illinois won't pay for ongoing care when you
are out of the area and my daughter needs an endo near her at school.  I
look forward to switching and I'm trying to find out what pumps are
considered "in-network" (used to be Minimed) so I know what my daughter can
get if she decides to get a pump.  It's too bad that it is so hard to find

Type 1 - 29 years, pumping 3+
and daughter Melinda, 18 Type 1 - 3 weeks.
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