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Why on Earth do insurance companies have to make it so hard???

Discussion in 'Parents of Children with Type 1' started by Lynnieg123, May 26, 2011.

  1. Lynnieg123

    Lynnieg123 Approved members

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    I'm just trying to determine my out of pocket expenses for an insulin pump so I can financially plan before I order it and each person I speak with at Aetna tells me something else. Then they tell me to go online and find a durable medical equipment place in my area to provide me with a 5 digit CPT code # yet the first 4 places I call on their list don't provide insulin pumps!?!?! I am on the verge of a l-o-n-g string of swears here. It shouldn't be so difficult. Why the heck can't they just look up Medtronic insulin pumps on a list and tell me what the cap is on it?!? #%^$@#(($:""l (that is me swearing) Did everyone have to go through this?
     
  2. caspi

    caspi Approved members

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    I am usually a very positive person and like to look at the glass as half full, but have a difficult time when dealing with insurance companies. My "conspiracy theory", if you will, is that they make it difficult so that we give up and they don't have to spend OUR money. :(
     
  3. Michelle'sMom

    Michelle'sMom Approved members

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    I would call the pump manufacturer & have them do the work for you. You're not obligated to purchase. Just tell them you'd like to know what it would cost OOP for you.
     
  4. Lynnieg123

    Lynnieg123 Approved members

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    My endo just gave me her contact's name at Medtronic. I am now in love with pump customer service. She found out in 15 minutes what I've been trying to found out for hours with several phone calls. I am officially off the ledge! I'm sure Animas would have been just as good but the company just lightened my stress load ten fold and didn't try to sell me anything! :)
     
  5. rdhead

    rdhead Approved members

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    I never dealt with the insurance company when being quoted for a price on an insulin pump. Because you are billed directly from the company they are the ones you should contact. Medtronic told me what the contracted rate was with our insurance. They told me what the pump price was, what my deductible was, my out of pocket after ins and what my 90 day supply price would be. There is no obligation just to get information from them.

    On the flip side of that my husband just recently changed jobs. At the time we were very fortunate to have 2 job offers at the same time. Both companies offering similar salaries and both had ins through the same company. However the coverage was different. I spent hours on the phone trying to find out what was covered under each plan and try to find out how much the prescriptions and pump supplies would cost. All I could get from the ins rep was pump supplies are considered durable medical equipment and she told me the percentage each plan covered. After becoming completely frustrated I decided to call my medtronic rep since that's where the supplies would come from anyway. In less than 5 min she was able to look up what the contracted rate was with the insurance company. I gave her the percentages each plan covered and she was able to tell me how much the supplies would cost under each plan. In the end we went with the company who paid just a little less but had better insurance coverage.

    Long story longer :p I would recommend calling the pump companies you are interested in and find out from them. They have all the info you need and there is no obligation just to get a price from them. Good luck! I jnkow how frustrating dealing with ins companies can be.
     
  6. ecs1516

    ecs1516 Approved members

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    We used to have Aetna and we got our pumps directly through the company. Like Medtronic and I think we were still on them when we got our Cozmo from Smiths Medical(out of business)
     
  7. L101418

    L101418 Approved members

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    I tried being proactive about pump costs also and contacted my insurance and they could not tell me anything until someone told me the pumps were not covered. Wha??!! That, of course, was not the case. Medtronic handled everything and in the end just called me with what my out-of-pocket would be before we commited to the purchase. Pumps in hand 3 business days later.
     
  8. bibrahim

    bibrahim Approved members

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    We decided on the pump we wanted and then during the approval process Medtronic gave us our out of pocket expense which was zero because we had met our yearly stop loss due to my daughter's hospitalization. So it worked out nicely. That may be the same for you if you had to pay a lot out of pocket at diagnoses. Now we pay 20% of the cost of pump supplies after meeting our deductible. The cost of insulin is a separate pharmacy cost. Mail order pharmacy is often cheaper also. Hope it works out well for you.
     
  9. Flutterby

    Flutterby Approved members

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    Let the pump company figure that out for you. Thats what they are there for.. They WILL NOT ship a pump until you are ready, most companies will make a payment plan with/for you if you have a balance left.

    I promise, its so much easier, and quicker, to just let the pump companies do it. They have professionals that are trained for this very thing.:cwds:
     

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