Question for pump users

[Evansdad]

My son who has had diabetes now for 5 months has been very interested in the pump. Today he begs us to call doctor to start process to get one. What is the process that we will have to do ? Is it easy to get one? Has it made life easier "he loves to eat but hates all the shots". Do they cost alot out of pocket? any other answers of help that you could reply back would be awesome ,so we know what to ask for and what we might miss.Also what might be a good pump to get?


thanks
Evansdad

[Thoover]

We were diagnosed Jan of 07 received our pump in May and started pumping June of 07.

You can call your insurance company and ask what they pay for the pump. I believe out out of pocket expense was only about $900.00

Our endo did the paperwork submitted it to the insurance company and that was it.. Ours was a very easy process.

Good for him wanting to do the pump.

Have you decided which pump to go with? You can call the pump companies and have them come to your house to show you the different pumps so you can get the feel and push the buttons..

[Evansdad]

we have not decide on pump just started today, any recommendations?

[TracieandJim]

I can help just a little. We are still pump shopping and lurking the threads for info to help us make a decision. We are battling out the differences between Animas and MiniMed. We will choose one of these before long. I went to their websites and requested info and began reading and asking questions on the forum. This past monday was our endo appt. and we asked and as hard as I thought it would it was crazy simple. She said OK just go to class. I sat there dumbfounded. I guess I went in thinking I would be on hands and knees. But we were told to go to class, do our homework assignment.. pass.. and the educator would recommend to the endo and then endo would approve or not. Sounds simple. I know we can do it. During the 2 hr class pump reps will be there to answer questions. If we pass and are approved we going to another class and the ball is rolling on from there.

As for cost. The pump manufacturer can verify with your insurance for you to see how much you are covered. All ya gotta do is ask. :)

[Sarah Maddie's Mom]

Endo filed request, denied 2x (very common) when approved covered in full as are the infusion sets.
Start with your Endo's office. Every Dr. has a slightly different protocol for this. Tons of info on past forum threads about different pumps. We have a Cozmo, love it but would be open to a change when insur will cover a new one, usually every 4 years.

[Lee]

I agree - go to a pump ed class and start the ball rolling. ALL of the pumps are great and you and your son will be able to get a feel for which one will work best for him.

Pumping is great ,but don't tell him no more shots ever, we still occasionally have to do shots due to pump issues. But, my DD will never go back full time to shots!

[jules12]

My son who has had diabetes now for 5 months has been very interested in the pump. Today he begs us to call doctor to start process to get one. What is the process that we will have to do ? Is it easy to get one? Has it made life easier "he loves to eat but hates all the shots". Do they cost alot out of pocket? any other answers of help that you could reply back would be awesome ,so we know what to ask for and what we might miss.Also what might be a good pump to get?


thanks
Evansdad


Our endo provided the brochures for three pumps at the hospital and we picked the one we wanted and called the company. The pump company took care of getting the clearance through the insurance and the prescription from the doctor.

$$ depends on your insurance. Most pumps and supplies fall under durable medical equipment. Find out what your cap is and if you have to meet any kind of deductible or do you have a split 80/20 so you have to pick up the 20 percent. Our pump company also worked with us so we can make payments on the remaining balance we owe for the pump. Also some insurance companies pay more for certain pumps than others.

There are four main pumps talked about on this forum and all have different features to offer - unfortunately, no one can really tell you what pump to get. You just need to research and pick the one for you. They are all good! :D


Look through this thread - it has a lot of good pumping info in it. You can also search for pumps and find lot's of threads where people are discussing differences in the various pumps.
http://forums.childrenwithdiabetes.com/showthread.php?t=16807&highlight=knew

[Sandy's mom]

We just ordered the Animas 2020 for our dd. Dh used to have the minimed and was happy with that too. We chose Animas because it gives the smallest doses of insulin at .025. Sandy is very insulin sensitive.

I'd first call your ins. company, see what brand pumps they cover, then call those pump companies and have their reps come to your home. See what your son thinks... Good Luck:)

[LJS118]

We love our pump. My son has been pumping now for over 6 years and won't go back to shots. It is more work, i feel, than shots. A lot of monitoring in order to make basal and insulin to carb changes. But all totally worth it. It allows much more freedom in eating than shots do, and sick day management is a lot easier than on shots. But the drawback is that it is a machine(or whatever it is technically called) and it can break down. Plus, it needs to be worn 24/7 (which my son has no problem with). They are also costly. Thankfully our insurance covers everything, but that's something you'll have to check with your insurance company about. When we were getting our pump Minimed handled everything...i just gave them the doctor's info and insurance info and they handled everything. I never made one phone call.
Do your research. Any questions ask away here--there's so many pumpers here. Good luck.

[TracieandJim]

Go to the sites I have listed below and sign up for them to send you a packet of info about their pumps. Each one has some thing good, different or better than the other. Its a very hard decision. Good luck!


http://www.minimed.com/index.html
http://www.animascorp.com/
http://www.cozmore.com
http://www.myomnipod.com/products/
http://www.disetronic-usa.com/dstrnc_us/

[Evansdad]

So i just called insurance company "ANTHEM" to ask about my coverage, And the guy had no idea what an insulin pump was!!!!!! :eek::mad::confused:

[hawkeyegirl]

So i just called insurance company "ANTHEM" to ask about my coverage, And the guy had no idea what an insulin pump was!!!!!! :eek::mad::confused:

Do you have someone at your endo's office who does pump training? If not, just call one of the pump companies, and tell them you are thinking about the pump, but not sure what your insurance coverage is. They will send you a form to sign that authorizes them to contact your insurance company re: reimbursement. Let either your pump trainer or the pump company do the legwork with your insurance company! They know all the right questions to ask, and who to talk to. (ETA: Make sure you tell the pump company you're NOT authorizing them to order the pump - that you're in the research stage and you just want to confirm insurance coverage first.)

[Evansdad]

We just called endo we have doctors appt on July 3rd for assessment? This includes drilling my son with question to make sure he is ready for the pump, next step is meet with nutrition person , then a test pump with saline , then overnight stay in hospital ...

[TracieandJim]

So i just called insurance company "ANTHEM" to ask about my coverage, And the guy had no idea what an insulin pump was!!!!!! :eek::mad::confused:

I had the same problem with United Healthcare the first time I called. Call back again. It may be listed under the 'durable medical equipment' portion of your policy.

And yes also call the endo's office. They may have some tricks for dealing with your insurance as well as the pump companies Im sure have their tricks too. :o

[TracieandJim]

We just called endo we have doctors appt on July 3rd for assessment? This includes drilling my son with question to make sure he is ready for the pump, next step is meet with nutrition person , then a test pump with saline , then overnight stay in hospital ...

:D Crazy huh! Congrats. Sounds like you are off to a good start. Looks like you will pumping before us.. SOOO jealous!!

[Momof4gr8kids]

I'd first call your insurance and make sure that it is something you can afford first. See if they have a preferred brand, and what pumping costs they cover.

Then talk to your doc and ask him, or her what the next steps are. Each doc has a different practice. I never went to pump class. I had one on one training.

If your insurance company doesn't have a preferred brand, you may want to have all of the reps out and play with each pump so you can see the menus, how they work, ect. Ask for samples of the sets offered by the pump company. Sets are a big deal once you start.

[TracieandJim]

I never went to pump class. I had one on one training.



Given YDMV, isnt there some sort of standard or guideline endo's should follow for new patients? We have to go to pump class, yet you didnt. One endo wont approve a pump but another doesnt even blink and approves. One endo wont write scripts for Blood ketone strips yet another will. I guess alot of it is the endos preference but its awful confusing and worrisome. Im just babbling.. ha

[Momof4gr8kids]

Given YDMV, isnt there some sort of standard or guideline endo's should follow for new patients? We have to go to pump class, yet you didnt. One endo wont approve a pump but another doesnt even blink and approves. One endo wont write scripts for Blood ketone strips yet another will. I guess alot of it is the endos preference but its awful confusing and worrisome. Im just babbling.. ha

I agree, but no, there is no set standard for an endo to follow. that's why it's so hard to give advice on how to start the process of a pump.
My daughters doctor was very pro pump, but also very pro MDI. he was quirky though. You could only use lantus, no NPH unless there was a problem with lantus, humalog, and novolog only, no apidra, one touch, or freestyle, nothing else, and at first he wouldn't prescribe a keytone meter.
They all have their own beliefs and ways of doing things, and it is confusing, worrisome, and makes it hard sometimes. That's why I love this forum. There are so many ways of doing things, and we get to hear about some that we would not have, otherwise.