A Little Worried


#1

I’m looking into getting a pump. I have to wait until the end of the year so I can use the insurance towards it and then use the new money in 2009 to get supplies. What kind of expenses are associated with using the pump? Supplies, insulin, back-up insulin. Does anyone have a record of what was needed/spent last year? I have a good job, I just want to make sure I don’t get in over my head.

Also, I live on my own, what sort of safety precautions should I put into place if I switched to the pump? With the pump things seem to happen a little quicker form what I’ve read as opposed to injections. I don’t think my dog can help with this issue. lol

Any thoughts?


#2

Not to get too personal Mike, but to figure out your costs, we would really need to know a lot. What is the copay on your insurance? What is the cap on your insurance pay per year? What pump are you planning to go on? etc.

You can figure most of this out on your own with a little investigating. Go to the product page of the pump company where you are planning to get your pump from. Check out the cost of the pump and infusion sets you are planning to get (don’t forget the reservoirs). Here’s a cost that usually doesn’t get reimbursed: Batteries. They don’t cost that much per year, but if you want to plan the expense out completely you should plan on them. Use the cost after deductions for insurance and you can get your net cost. Pump supplies are usually sold in 1 month or 3 month supplies (should be stated on product page). Also, if you are using a pump with the CGMS, that is an added cost too.

You need to keep syringes and insulin available in case you pull your pump out accidentally and need to take some insulin so you don’t go too high. I just keep an extra infusion set in my car, at work, and places I frequent often. If my pump pulls out, I use the new infusion set and the old reservoir, just to get me through. But this won’t work with all pumps… some have the infusion set and reservoir all in one unit.

If you don’t already, it’s a good idea to keep some glucose tablets (or gel) close to your bed, in case you drop low while sleeping. Unless you can teach Fido to fetch glucose for you… lol. Actually, I don’t go anywhere without a snack bag with glucose tablets in it.

That’s about all I can think of at the moment. If anyone else has something that i forgot, please chime in.

-Bill


#3

Find out what your lifetime maximum coverage is for durable medical equipment for your insurance policy. I maxed out one of my previous policy’s DME coverage (from non-diabetic equipment), so from that point on, everything was out-of-pocket.

I am in the throws of insurance appeals to get a pump right now (different insurance company than stated above). I am having a very hard time. Unless you have good coverage, or have absolutely horrible control over your diabetes, expect a fight.

Recently I was quoted $4,500 for a Minimed pump, and approx. $120/month for supplies. My insurance policy claims they will pay 80% after a $1,000 deductible, but that is after pre-approval. But… they won’t approve it. Just a heads up.

BTW… you can get a Diabetic Alert Dog… but they are upwards of $6,000. :slight_smile:


#4

Thanks for the info. Bill!!! I guess writing this up at work wasn’t the greatest idea since there are so many distractions. I was looking at a MiniMed, my insurance covers up to $2,500. I talked some more with my HR lady and the question of the day is whether or not I can keep dipping into the DME coverage throughout the year since, like you said, I can only get so much at once.

Thanks for bringing up some good questions!

-Mike


#5

Thanks for the information Salty and Sweet! :wink: I didn’t even think about a lifetime max, good question!

That sucks that the insurance company is giving you crap, like we choose to have diabetes! I have to chuckle when I call to get a refill on Humalog and they say my prescription ran out. My standard replay is: that’s funny I didn’t run out of diabetes.

I’m not sure which insurance you are working with, I’m under United Health Care. Keep my posted on your trials and tribulations and I’ll do the same.

Thanks again!

-Mike


#6

I have United and my doctor said they are one of the few “friendly” providers. They are also one of the few that cover CGM.

I just got my Minimed pump and was covered 100%, with no out of pocket (well, except for paying $24.99 for the Quickserter). My medical policy is underwritten by the employer and is consider self-funded, which means the employer decides what is covered, versus United… so that may differ from your coverage. Regardless, United is generally friendly to our needs.


#7

Shawn and Mike,
Are either of your companies hiring?
Just kidding. I love my job, just hate the “benefits”.


#8

Shawn,

That’s very encouraging to hear! How do you handle the supplies? Is that covered? Does that fall under DME for you? Sorry to pry, just trying to get all my facts/info. together as I negotiate with UHC.

Thanks!


#9

As I mentioned, I just got my pump, so I am not sure how the supplies will be handled. The initial round of supplies were included, so I am assuming I should not have a deductible. Good luck!


#10

You have to test your BS more often. Your going to need to buy more BS test strips. It depends on how much insulin you need and what type of insulin they put you on with the pump. I used 2-humalog and Lantus before and now I use humalog. I use 3 boxes a month. My insurance cover the supplies for my minimed pump. Need tablets to treat low blood sugars