Trying to get a new pump

crashandburn · #1 03-02-2011, 11:42 AM

Ok so i had a pump through medtronic a few years ago not sure how long and have been talking to a animas rep and also im working on getting the cgm because my doctor thinks it will give me alot more control. Anyway i was talking to the rep earlier and she said if it hasnt been more then 4 years then my insurance company is allowed to deny me, which sounds pretty unreasonable if you ask me considering what i pay a year represents about what 2 pumps would cost. I am just curious if anyone else has had an issue with this and if you were able to bypass this problem and get it and how you did this?

Amy C. · #2 03-02-2011, 11:48 AM

This is a commone practice. I don't know of many insurance companies who will pay for a new pump if the old one is still under warranty -- typically about 4 years. Even then, some even require something to be wrong with the pump before replacing it.

crashandburn · #3 03-02-2011, 11:52 AM

well medtronic wasnt very helpful and was also overcharging me it seems for supplies by quite alot i would keep with them but when they are charging me over $300 for supplies and animas said they would only charge me like $140 then something just isnt right

crashandburn · #4 03-02-2011, 11:53 AM

do you know if there is any chance my doctor can talk them into covering some of it or if there is something else that i can do?

Amy C. · #5 03-02-2011, 12:36 PM

It sounds like the warranty is almost up. You can call MM to find out.

It seems you would have less than a year to wait.

MM has a CGM with the pump, but Animas uses Dexcom. You could start working on getting the Dexcom.

crashandburn · #6 03-02-2011, 12:42 PM

think it would be better for my sugars and a1c if i didnt have to wait a year because ive noticed im entirely in control with a pump and im trying to talk to dexcom now and im working on getting it so the animas pump would be nice too because i kinda cant stand medtronic one of the worst companies ive dealt with and i might have to end up paying for the pump through straight cash though i can hardly afford that

mocha · #7 03-02-2011, 07:23 PM

I would recommend trying to get the CGM separately at least for now while you're waiting for the pump if you and your doctor think that it's right for you.

Most insurance companies are miserable to work with at best, and diabetes coverage is one thing that my family and I have found that they love to try and not cover. If you've talked with your insurance company and they won't cover a new pump while your current one is under warranty, there really isn't anything you can do unless you want to purchase a pump out of pocket.

Is your insurance company going to cover the CGM and the sensors as well?

crashandburn · #8 03-03-2011, 12:54 AM

i was told my insurance should cover the cgm and supplies so yes and i might end up having to pay for the pump out of pocket if it comes to it but id rather avoid that since i have insurance for that very purpose

mocha · #9 03-03-2011, 07:17 PM

I understand that you're not happy with Medtronic.

How much longer do you have left with your current pump?

PatriciaMidwest · #10 03-03-2011, 09:14 PM

You might want to look at the offer Omnipod has out right now. It's only available to people who ARE under warranty. I don't mean to sound like a salesman but it's a great deal and does not use up a pump purchase with your insurer. You pay $200 out of pocket to get started.

We have a year left on our MM Revel warranty and just did the Omnipod deal. You still keep your old pump. If a new and better pump comes along next year when our MM warranty runs out, our insurance should cover it.

http://www.myomnipod.com/customer-ca...ified-pumpers/

The promo is scheduled to end on 3/31.