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Re: [IP] Insurance

> The ongoing saga of the insurance battle............despite having
> told me (before I bought a pump) that pump supplies would be covered
> at 100% as durable medical equipment, the insurance company has
> changed its mind and denied me coverage of supplies as DME.  I will
> only be covered at 50%.  This is because supplies can only be
> purchased from medical supply houses which are not in-network
> providers.  If I could get supplies are a pharmacy, they would be
> covered 75%.  So if supplies are pharmaceutical items, why can't I
> find them at any pharmacies?

Simply have the pharmacy order the supplies for you.

take the insurance company to task. The supplies are DME for most 
other insurers and they already told you YES so they are actually 
contractually stuck with it. You will probably have to duke it out 
with them, but start now with an appeal, followed by a call to their 
Medical Directors office, followed by a complaint to the state 
insurance commissioners office. Make sure and copy you local congress 
person on everything, perhaps they will even get involved. If you 
have a friend in the newspaper business, involve them as well.

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