pump cost?

[Liongirl4]

I am SO frustated this morning after making phone calls to insurance, medtronics..are there actual live people that work there, because I don't think so!!
Can you give me an idea what the pump actually costs (we are getting medtronic minimed)..I know I have an 80% copay, and medtronic said my share would be $2800!! Something about there is a cap on DME's. with my insurance. Is this kind of high or the norm??
Rose

[Nancy in VA]

I think an average of $5000 is a good number.

20% of that would be $1000

Your insurance plan may have a cap on DME reimbursement - mine doesn't. But, if there is a cap perhaps you can appeal for a lifting of the cap for this - its a once every FOUR YEAR purchase and you can do the strict 20% instead of 20%+ everything over the cap. It will probably take a few extra phone calls, I imagine.

[Lee]

Yep...we had the 20% copay. It does cost about $6 grand...plus all the other stuff.

Have you called your State to see if there is any aid. When we started the pump, we had Children with Special Heath Needs that helped cover the copay. It was a mid-income type of financial aid. Now, I make about $200 to much, so my copays eat all of my extra income.

[Kaylee's Mommy]

The cost of the pump starter set is about $7,000, that should be with your first 3month supply of the infusion sets and reseviors.. I don't know what your insurance company has for DME, I'd call them and find out. We paid $750 out of pocket, but our insurance company covered 90% of everything.

MM will do a payment plan for you.. we JUST paid kaylee's off two months ago.. we paid $55 a month for alittle bit over a year.. it was something we could easily fit into our budget.. :)

who do you have for insurance? it may be worth it for you to look into A plus medical. They carry the mm sets and reservoirs.. and they don't charge you a co-pay. But your insurance company has to be willing to work with them..

[jules12]

Our pump was in the 5-6,000 range and we had 80/20 split on durable med but the kicker is that the $1000 deductible had to be paid first before the 80/20 split started. Fortunately for us, we started the pump the same year as our initial diagnosis and hospital visit so we had met the deductible and now have met the total out of pocket expenses so the supplies every three months are covered completely. However for the pump we ended up paying about $1100. Since we are still paying off hopsital, doctor, scripts, etc, we use the minimed payment plan too and it works great!

I am not looking forward to the new year starting and having to meet all the deductibles again - and as I posted in another thread - possibly new insurance!!!

[Abby-Dabby-Doo]

Rose~
I'm curious to why you are handling this?
Do you have a pump rep? There is a page at the back of the informational packet that the pump rep has you fill out. THEY turn it in, THEY do the work for you. It doesn't mean you have to get that pump, it's just so they can give you the cost. They contact the insurance company so you don't have to go through all of this. If you don't have a pump rep, let me know and I'll give you the phone number for mine and he'll put you in touch with the right people.
IMO - Your going to get the run around from MM because that isn't the way it generally happens.

[haileysmom]

that sounds pretty much on target. our pump is going to cost us about 1200, our insurance is covering us at 80 20 and we have no out of pocket cap either. they have a payment plan though. 50 a month till it's paid off...

[EmsMom]

After much talking between my HR department and letters from our CDE/pump rep helping us with the pump and I think the doctors office we were able to change the classification on the pump from DME to diabetic supplies. Most HR departments can make that change with the insurance provider and in the case of Blue Cross Blue Shield it was an option for the company that HR didn't know anything about. That still has the 80/20 copay in my case which is better than the DME copy was, but it still helps out. The company we went through to get Emma's pump was great and they just added our out of pocket to her supplies cost every 3 months so it got spread out over the year.

[clb1968]

I just got my EOB from my insurance for my pump.
I have 20/80 for me DME and I had already met the deductable , so my 20% for the pump was $899 and then 94.88 for the 20% on the supplies and this is all on the payment plan I have with MM and I pay 50 a month.


The pump cost 6195.00 with out discounts or insurance , for the MM722

[Liongirl4]

I am faxing papers back to Medtronic tomorrow..my co-pay came to $1080..quite a bit less then $2800! The Medtronic reps have been great..but my insurance didn't have any record of them contacting for info...I guess in the end it will all pan out.
We still wish we had an idea WHEN the pump might come and WHEN Samamtha can get hooked up..my schedule at my job is posted through Christmas, and its not easy to switch or take off.(I am a nurse).
I know..patience is a virture!!
Rose