I just wanted to see if anyone else has Blue Cross and has received their pump less than 6 months after dx? I just got off the phone with Animas and they said they received our paperwork yesterday. The only thing that may be an issue is that my dd was dx'd 3/31/10 and the rep said Blue Cross only covers the pump 6 mo. after dx. He did say that they can send additional paperwork to try and get it covered sooner, but no guarantee. I just wanted to see if any of you experienced this and what the outcome was. I'm in CA if that matters as far as the insurance coverage.
Well, BCBS is a big entity, and their insurance varies wildly from policy to policy and state to state, but we have BCBS HMO of Illinois, and I believe our pump was approved at approximately 4 months post-diagnosis.
Thanks.... I hope they cover it now because it would be so much easier starting the pump in the summer while schools out! I'm keeping my fingers crossed...
We have Anthem Blue Cross in CA. We were denied the pump when we tried to get one before Alanzo's 6 month dx anniversary even though our endo submitted a letter of medical necessity and we submitted numbers for the past month. They later denied our appeal. However, about two weeks before the 6 months was up, Animas resubmitted the paperwork and Blue Cross gave their approval.
That doesn't sound good If it happens that way then she would be starting in September / October, beginning of the school year, new school and a lot more students... That on top of the fact that CA is a mess as far as nurses in schools go. Things aren't looking to hopeful here
I think it depends on your plan. We have a really flexible plan and we were approved at 4 months post dx but did not start until just at 6 months (I wanted to get thru the holidays first) We have BCBS - Highmark Pennsylvania.
We have BCBS of Minnesota, and dd was pumping 3 1/2 months after diagnosis, fully covered by insurance. Her CGM had been approved, as well, though we didn't start that right away. I think it depends your particular entity and plan.
BCBS of Alabama here and they approved us when we called in the hospital inquiring only question was what percentage they covered, all depended on how much of our deductible we met.
I hope that they surprise me by covering it! We have a pretty good plan, it's a PPO. I am sure that once they finish processing that $33K bill for her dx from the hospital, that we should be covered as far as deductable goes. I'm keeping my fingers crossed!
We have BCBS and they approved the pump no problem - we were pumping 1 month after dx. They did, however, prove difficult for cgms and I had to go all the way to the 2nd level appeal process.
We have BCBS Healthselect of Texas. We got our pump approved around 3 months after dx and were pumping before the 4 month mark.
