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Out-of-warranty required

Discussion in 'Parents of Children with Type 1' started by lilituc, Jun 8, 2010.

  1. lilituc

    lilituc Approved members

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    I've been looking into different pumps (my 522 warranty is up in December), and yesterday Animas called me about my insurance coverage.

    The guy said that my insurance company (which sounds like a mountain), won't pay for a new pump until it's out of warranty and broken. He really emphasized that no major insurance company will pay for a new pump until the old one is out of warranty. I asked him if my secondary insurance company would pay for it (since they didn't originally), and he wasn't even going to check. Finally he said he'd talk to someone else and call me back today.

    As far as I can tell, having an out-of-warranty pump is not a great thing with MM. They might get you a new one if it breaks, but only if you stay with them.

    Now, I know I could wait until December. The thing is, other people have switched pumps in midstream, so to speak. Is this a new policy by all the insurance companies? Can anyone enlighten me?
     
  2. Sarah Maddie's Mom

    Sarah Maddie's Mom Approved members

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    Our insurance company also required that the out of warranty pump be malfunctioning before they would spring for a new one. Of course, "malfunctioning" is a very broad term :rolleyes:

    Good luck with your transition.
     
  3. hawkeyegirl

    hawkeyegirl Approved members

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    I think most insurance companies will not pay for a new pump until it's out of warranty. I think some Cozmo users got special dispensation for new pumps since the company went out of business. But otherwise, I think you're usually stuck waiting at least until it's out of warranty, and sometimes until it malfunctions (although you can usually find SOMETHING wrong with a 4 year old pump. ;))

    My understanding with MM is that if you are out of warranty and your pump breaks, they will loan you one for 30 days while you decide what you're going to do.
     
  4. Flutterby

    Flutterby Approved members

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    Being out of warrenty and 'maybe' getting a replacement pump is wrong. MM WILL replace an out of warrenty pump. They will give you up to 90 days WITHOUT charge.. if you decide to go with MM, they'll send you a brand new pump, you'll send the replacement back, if you decide to go with a different company, you send the replacement back within that 90 days.. MM will NEVER leave you hanging like that.. That was one of my concerns, I've asked several reps about it.

    That being said, I WAS able to gain FULL 100% coverage for Kaylee's revel while her 522 was still in warrenty.. It took work, more work than it normally would take to get a pump.. Funny as someone at our insurance company told MM flat out that if its in warrenty they WOULD NOT cover another pump. 2 days later I got an EOB from the insurance company that they covered her new Revel, and two days after that got news that the secondary covered the 20% the primary didn't cover.

    Wanted to add, when we started looking into getting the Revel covered it was March, warrenty was up on June 1st, so we were pretty close.. and MM flat out told the insurance company, they pay now, or the pay june 2nd (our insurance will pay as soon as warrenty is up.. it doesn't need to be broken).. Honestly, the guy I delt with at MM was awesome.. he went above and beyond what he normally does.
     
  5. lilituc

    lilituc Approved members

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    Thanks, everyone. The guy called back today and left a message saying that I can't use the secondary insurance if I have the primary insurance. The best I can make sense of that was it doesn't sound like he's very experienced, so I think he was trying to repeat the reason and left some of it out.

    I've definitely heard of the secondary insurance picking up the cost of a new pump after the primary denied it. It may be that they're all suddenly making more of an effort not to pay, or this particular company doesn't do that. They've definitely picked up expenses that were denied by my primary insurance as not necessary before, but a pump costs a lot more.
     
  6. jilmarie

    jilmarie Approved members

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    I think you just need to wait until your warranty is up until you try to replace it. As Kaylee's mom said, they'll send you a replacement that's good for 90 days if it breaks during the transition period. It's just a lot less complicated to replace a pump once the warranty is up. At that time, if your insurance company requires that the pump is broken, send it back with a scratched screen or something else minor.
     
  7. Gracie'sMom

    Gracie'sMom Approved members

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    I don't know which pumps you were interested in, but OmniPod has the deal for $299, they do not put it thru your insurance at all, you can get an OmniPod, if the pod's are covered by your insurance (they do check that first). It may not interest you at all to get an omnipod or pay $299, but just in case I thought I would mention it. We are thinking of switching if they get the dexcom integration first, which looks to be very likely.
     

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