Dealing with Insurance

So how DO you get a pump, after you have decided to get a pump?

If you are a lucky you are going to an endo who will guide through the whole process. I would suggest that you look at ALL the pump companies though, and not just pick something your doctor likes. YOU are wearing it, NOT him.

If however, you are dealing with a primary care physician and they haven’t done it before, here are some hints.

And try not to be on an HMO.

Well, first, your doctor has to agree, and write a letter of medical necessity. However, the pump company will help you with that. They have done a bunch of these before, and they know how to do it.

You will either get accepted or denied. If you get denied, then you need to decide if you can afford the pump and its supplies. My insurance company denied both, which is why I have filed a complaint with the state. The state of Texas requires that pump supplies be paid.

If you can afford the pump and supplies — and I will warn you, I’m spending about $600 every 3 months on supplies — then you will buy everything yourself.
Here again, I advise using the pump company.

If you get denied and you think you shouldn’t have, and you can afford it, go ahead and get the pump like I did, and just keep filing paperwork at them. It’s fine to take a few weeks to take a breath, I did that several times, but keep at them.

I still haven’t gotten mine paid, but I have given up. I’ll keep everyone abreast with one is going on with this and I would love comments from others on it.

Here’s where I am at.

I’ve got a complaint in to the state insurance board, and I have an independent review in to the insurance company.