- advertisement -

Blue Cross covering pump before 6 mo.?

Discussion in 'Parents of Children with Type 1' started by yelley, Jun 11, 2010.

  1. yelley

    yelley Approved members

    Joined:
    Apr 9, 2010
    Messages:
    74
    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.
     
  2. hawkeyegirl

    hawkeyegirl Approved members

    Joined:
    Nov 15, 2007
    Messages:
    13,157
    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.
     
  3. yelley

    yelley Approved members

    Joined:
    Apr 9, 2010
    Messages:
    74
    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...
     
  4. LittleGuy'sMom

    LittleGuy'sMom Approved members

    Joined:
    Jan 22, 2010
    Messages:
    198
    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.
     
  5. yelley

    yelley Approved members

    Joined:
    Apr 9, 2010
    Messages:
    74
    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
     
  6. wvchinacat

    wvchinacat Approved members

    Joined:
    Jul 23, 2008
    Messages:
    957
    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.
     
  7. slpmom2

    slpmom2 Approved members

    Joined:
    May 16, 2008
    Messages:
    641
    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.
     
  8. mom24grlz

    mom24grlz Approved members

    Joined:
    Mar 30, 2010
    Messages:
    1,799
    interesting. we have blue cross so i assume we'll have to wait 6 months also.
     
  9. nikichickee

    nikichickee Approved members

    Joined:
    May 8, 2010
    Messages:
    123
    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.
     
  10. yelley

    yelley Approved members

    Joined:
    Apr 9, 2010
    Messages:
    74
    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!
     
  11. jules12

    jules12 Approved members

    Joined:
    May 26, 2007
    Messages:
    2,333
    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.
     
  12. sarahconnormom

    sarahconnormom Approved members

    Joined:
    Mar 12, 2008
    Messages:
    626
    We have BCBS Healthselect of Texas. We got our pump approved around 3 months after dx and were pumping before the 4 month mark.
     
  13. Meghan'smom

    Meghan'smom Approved members

    Joined:
    Jan 3, 2009
    Messages:
    249
    We have BC/BS of CT and Meghan had to wait 6 months for her pump.
     

Share This Page

- advertisement -

  1. This site uses cookies to help personalise content, tailor your experience and to keep you logged in if you register.
    By continuing to use this site, you are consenting to our use of cookies.
    Dismiss Notice