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URGENT Insurance/Pump Issues

Discussion in 'Insurance Issues' started by Missynoodle, Mar 28, 2018.

  1. Missynoodle

    Missynoodle New Member

    Joined:
    Feb 6, 2015
    Messages:
    2
    In 2012 we adopted an 8 year old child with Type 1 Diabetes from foster care. As part of the “special needs” adoption, Henry kept his state Medicaid. Since that time, we have added him to my employer’s insurance with Anthem Blue Cross Blue Shield. Everything was going just fine until this year. When trying to order the insulin infusion sites and reservoirs needed for his insulin pump from MiniMed. I was told that they no longer have a contract with BCBS and therefore would not be able to provide supplies to us any longer. When I asked them to skip BCBS and just bill the Medicaid, they said that they are unable to do that as it would be insurance fraud. I have called SEVERAL companies. Some will take BCBS, but since they don’t accept Medicaid they cannot bill me due to laws with Medicaid. Some will take Medicaid, but won’t accept because they don’t take BCBS. I seem to be in a catch 22 situation.

    The children's hospital that my child goes to has tried to help, but they have hit a brick wall. We currently have a couple of weeks left of sites. I have written to our congressman and am anxiously awaiting a response or help from him.

    Questions.....Has anyone else ran into this problem and found a resolution?
    Has anyone ever switched pump companies in the middle of a contract? If BCBS won't accept Minimed, then it seems to me that we should be allowed to switch companies. If you have switched, how did you go about getting it done?

    The last time I discussed this situation with the doctor’s office I was told that I may just have to take him off of the insulin pump and put him back on shots. I am EXTREMELY frustrated by this. We have two forms of insurance for him, yet are going to have subpar health care.

    I am praying that some Mom or Dad on here has fought this fight and will help me know where else to go to fight it.

    Thanks a million in advance for your help!
    Missy

    Hannah, 24, dxd 07/06 Henry, 14, dxd 08/09
     

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