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How often does your insurance pay for a new pump?

Discussion in 'Parents of Children with Type 1' started by Marina, Jan 21, 2010.

  1. Marina

    Marina Approved members

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    We have been pumping for a few years now, and I had been hoping we could get a new pump this year. Our insurance has just informed us that they will only pay for a new pump if it is "medically necessary". Any experiences / advice??

    Many thanks,
    Marina
    (mother to Emil, 5, dx 10/2006)
     
  2. Jilleighn

    Jilleighn Approved members

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    We were told our insurance will pay for a new pump when the Warrenty goes out on the pump, which I think is every 4 years.
     
  3. ecs1516

    ecs1516 Approved members

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    Aetna and United replaced our pump every 3 three years. First time was to get a smaller basal than what we had. The endo wrote that we had to have it and it went thru.
     
  4. Toni

    Toni Banned

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    Most insurance companies will pay when warranty is up. Without warranty the pump companies won't support the pump, will they? Honestly don't know about this. Sis did have Oxford once but they switched over to United. Oxford's policy was "one pump for LIFE." For whatever reason. Unbelievable!
     
  5. tiffanie1717

    tiffanie1717 Approved members

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    4 years for us.
     
  6. owensmom

    owensmom Approved members

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    In Canada it is every 5 years. Warranty is up in 4 though:eek:
     
  7. ecs1516

    ecs1516 Approved members

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    Our paperwork on our medical policy is where it listed the new pump every three years. You may want to check your paperwork on your policy then give them a call.
     
  8. diabetesgoddess

    diabetesgoddess Approved members

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    Our provincial program covers pumps every 4 years. Our pump is waranteed for 5 but I will get a new one in 4 so that we have one last pump on the government :)
    Private insurance can range from once per lifetime to every 4 years.
     
  9. momtocharlotte

    momtocharlotte Approved members

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    We managed to get Charlotte her new Animas Ping this year since we'd had a change in insurance plan. Otherwise, on our old plan DME replacement was only every 5 years unless there was some sort of problem with the equipment and it could not be repaired. Also, I work in the health insurance industry as a RN Case Manger and see that a lot of plans have this 5 year replacement clause in their policies. Hopefully, you'll be able to work around that with your endo...maybe have him write a letter explaining that a new pump is needed for "x" reason. Good luck!
     
  10. sarahspins

    sarahspins Approved members

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    Some are 4 years AND the prior pump has to malfunction while out of warranty. It's best to check with your own policy.
     
  11. Beach bum

    Beach bum Approved members

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    Every 3 years:D
     
  12. s0ccerfreak

    s0ccerfreak Approved members

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    Every 4 years or if there is a new pump (with significant changes) that help me manage my diabetes better.
     
  13. Amy C.

    Amy C. Approved members

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    That is what it is with Blue Cross Blue Shield of Texas. My son's pump already qualifies to be replaced (scratched screen), but we are holding out until next September when he can get a Ping.
     

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