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Re: [IP] how to get 100 % reimbursement: question, not answer :)

The pump is not surgery, it's not implanted. It's durable medical equipment,
like an oxygen concentrator.  If the DME is covered at 80% that's just the
plan that you have, and I don't think you can argue them into changing that
unless you change your plan.  Which might be difficult.

Another thing is to find out what your co-insurance max is.  Usually its an
amount that you have to meet out of pocket before they will start paying
100%.   If your having financial hardships. Minimed will work out payment
plans that are interest free, and you have 4 years to pay off. Also you can
talk to their financial person and they might work out a deal to write off
the 20%, but you really have to show your financially unable to pay.

Mine has a $1750 co insurance max after I meet my $350 deductible. This
doesn't count prescriptions but does include pump supplies.  I had 2 sleep
studies done, and a few other things I met my insurance max. YIKES. So until
the end of the year I have 100% coverage.

----- Original Message ----- 
From: "ruth jennison" <email @ redacted>

Hi there all,

Here's an insurance question. My insurance has agreed to 80%-- which is how
they cover my prescriptions. Seems to me that the pump is qualitatively
different than a prescription, and might be classified more like a surgery
or other invasive procedure, which they cover at 100%. Has anyone had luck
getting their insurance to reimburse the full 100%?  If so, what arguments
did you use? Just a poor graduate student posing the question ;)

As always, thanks in advance for any replies.

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