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Re: [IP] Battling the insurance company



Sherry
My pump supplies are covered under my medical plan as durable 
medical good I would have to paid a persentage of total cost. But 
because they are a prescription item they are covered under my 
prescription plan but only through the mail order service not at the 
local pharm or for reimbuirsment. I choose to use the mail service 
because it is cheaper.
Gail

Date sent:      	Tue, 25 Sep 2001 10:08:19 -0500
From:           	"Sherry Compton" <email @ redacted>
Organization:   	Western Kentucky University
To:             	"email @ redacted" <email @ redacted>
Subject:        	[IP] Battling the insurance company
Send reply to:  	email @ redacted


(I hope I'm not sending this twice.  I think this post was lost in space
because I  haven't seen it on the last 3 or 4 digests.  If it is a repeat, I
apologize. Since writing this I have emailed the problem to the HR head, but
she hasn't answered. I doubt she will be much help.)

Okay, many of you remember my whining the other day about the cost of my
deductible for pump supplies, which my insurance currently classifies as
"durable medical". A few people said I should call the insurance company and
ask for written proof of why it is classified that way.  I called and the
customer service rep. could find no mention of pump supplies or tubing.  She
said it was covered as "other" and offered no more help. I then made some
calls and found out that the 90 supply day mail order prescription service we
have will supply tubing and reservoirs.
Doesn't that seem to imply that it should be under prescription services? And
in-network?
Does anyone have any other suggestions on what to do?  Shall I call back and
just be very assertive to the customer service reps at the insurance company?
Should I write a very formal letter? Should I have my doctor call?
What is the most effective way of dealing with the insurance monster when they

classify something one way, but have no written proof?

Sherry C
>From the massive city of Bowling Green, KY
Who can't afford $1400 per year deductible plus 20% copay and is somewhat meek

about dealing with strangers
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Gail J Donohue
email @ redacted
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