Discussion in 'Parents of Children with Type 1' started by OneTwinWithJD, Feb 8, 2008.
Do most insurances cover the pump?
What is the cost of the pump on average?
...waiting...refreshing...can't wait to see answers!
Totally wondering the same thing! I've heard really discouraging info on this...and Charlotte has ruined two ipod nanos (my little pre-pump test). Not sure how this whole multi-thousand dollar equipment thing is going to go....
I think most cover the cost to some degree. Probably 80/20 for most? We are extremely lucky and ours covers it and everything else 100% with no copays.
I think on average all pumps except the omnipod cost around 5-6k.
The paper from Animas listed the 2020 as a few dollars under $6000. Can't remember the exact amt. something like $5975. Our insurance covers all pumps under DME at 100% and all DME supplies at 100%. We have Cigna POS.
We were on BCBS at the time and they cover pump/supplies 100% (for the plan we were on).
We are now on UHC and while I don't know what they cover for the pump, they cover 100% for sets, and cartridges and don't cover preps, wipes or dressings. Animas gives us a discount on those items not covered by insurance.
I think they are about $5000. I think most insurance covers them if medical necessity can be established. I was really worried about that aspect of it because our son has always had relatively low A1Cs...so I was afraid they wouldn't think it was necessary. But out doctor wrote a very convincing letter about fearing undetected lows. So while it went for review we were approved without a fight.
They are under warranty for four years. And we have added the pump to our homeowners insurance in case any non-warranty issues happen to it.
As far as how much of our insurance covers it, we have a high deductible plan but Ryan was diagnosed in January 2006 and hospitalized for 2 days so our deductible was met so the pump for us was paid 100%.
The cost usually depends on what is available under your durable med. You can call your insurance company and aske about your Durable Medical Equipment Coverage.
Our insurance isn't the greatest and we have a 1,000 deductible and then it is covered 80/20. So if the pump is 6000, we would owe 2000 for the pump. Our pump supplies are covered 80/20 after the 1,000 deductible is paid.
Our insurance also pays 100% for durable medical. If I remember correctly the list for the Minimed was around $6500 and our insurance actually paid around $5500. That was a couple of years ago so my numbers may be slightly off. As someone already mentioned, check under the durable medical equipment section of your insurance policy.
We paid a total of $75 (copay) for Jason's pump. I believe it (Animas 2020) was around $7K.
when I got my pump in 2000, we had Aetna and it was covered 90%, with the remainder coming out of our pocket over a few months' time.
Grace has BCBS PPO and hers was covered 100% no questions asked, but that doesn't tell me how much work goes on behind-the-scenes-- I know that many pump companies can do all the legwork for you, so if Dr had to write a letter of medical necessity, I never knew. The only thing we paid for was the site inserter.
The insurance we had when we got the pump paid 80%, or was it 90%, one of the 2, I can't remember. Our current insurance would pay 100%.
My BCBS paid at 80/20. so my cost for pump was 1100 and that included the first 90 days of supplies for my MM 722. MM let me pay the 1100 out at 50 a month.
Ours was covered at 100% with all supplies at 100%. IIRC, the pump invoice was $5995 and the supplies are close to $300 a month. That is the killer-- the supplies!
my insuance (tricare south region) covers 100% they payed a little over $6k
Retail pump prices from DiabeticInvestor:
MiniMed 722 $6,195
Animas 2020 $5,975
Deltec Cozmore $5,595
Accu-Chek Spirit $6,195
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