Just an update on the saga of the pump… at this point all providers have refused to process the order based on a high C-Peptide test. It was high last year when I first went on Medicare as well (my pre-Medicare pump was still under warranty), but Medtronic appealed and my supplies were approved, so I’ve been getting supplies through Medtronic just fine for about a year.
Now that I’m considering switching it’s come up again and since I’m on Aetna, not Medicare “classic”, no one wants to bother with it. Grr.
I might have to step back and try to see if Medtronic will work with Aetna and just stick with them. My experience is they’ll fight pretty hard to get insurance worked out.
You have my sympathies with Aetna. I’m old enough to have been covered under nearly all of the major insurance carriers in the USA. Cigna was worst, but Aetna nips at its heels in their horrible decisions, customer facing technology and poor customer service.
I can’t even begin to express the stress and frustration that is the demon named Edgepark. I used to order my supplies directly through Roche (at the time that is what I was using), but after switching to a different insurance plan at work (same company mind you) that had more coverage for supplies and no deductibles, but just didn’t allow going out of network, I randomly got force switched to Edgepark. My insurance company didn’t tell me anything, they just denied my order from Roche and then when I never got my supplies I called and they told me the insurance told them that I was being switched to Edgepark. The funny thing is Roche was in network with the other plan, so that is very weird. On top of that, Edgepark charges 2-3x as much for supplies than the manufacturers do, so I can’t for the life of me understand why they force me to use a distribution company. If that doesn’t speak to the corruption and everything else that is wrong with our healthcare system, i don’t know what does.
Every order I place for the full 3 months worth of supplies I have I have to call because Edgepark says it is more than I am approved for, even though I have the prescription and my insurance says they won’t deny it as they go by the prescribed amount. I have to talk to 4 different people on the phone until finally getting someone who is able to make it work, only to have the same issues next time. Their “customer service” reps are DEPLORABLE. They truly know nothing about what they are doing or what the supplies are. Their online ordering is absolutely horrible too. That is just the tip of the iceberg. They do have a diabetes specific number that can help with ordering, but they can’t help with billing or anything else it would seem, and I really prefer not to have to call to order supplies.
I called my insurance and they only gave me a few options to choose from, one being Edgepark, one not having the supplies I use now (Tandem), and the other being Byram. I really don’t even trust my insurance reps to be giving me accurate information on things in general… I have hesitated to go to Byram as reviews for them are equally bad, but so far it seems that quite a few people on here have been relatively positive about them so i think I will give them a shot since I am not spending any more money with Edgepark. But, I know they don’t give a crap because they know their deals with the insurance companies means most people don’t have a choice so they really don’t have to worry about keeping people’s business.
I have Aetna through a large company. And when I switched from Medtronic to Tandem, Tandem told me I would have to get my supplies with Edgepark. I have been using Edgepark for almost 3 years now and have had no problems. But I do everything online. They send me notices when i’m due for an order and I can make any changes I need. I guess i’ve been lucky that I don’t have to call about insurance changes, pump changes, makes it easy. Dexcom does work with Aetna and again, I do it all online. Pretty easy.
edgepark sucks. i had so many issues with them. they only do insurance verification once. if you have a gap they dont care. they will bill you no matter what you tell them its their mistake. They wont admit they made a mistake. They are suppose to do insurance verifications and again they didnt when i ended up having the issue. If i known about the issue i wouldnt of renew the order. So i avoid edgepark now. Liberty is now part of edgepark. I now go through CCS now that i got medicare to cover the supplies (had to wait about two months) and i have my dexcom supplies through a local medical supplier.
I do all my ordering online with Edgepark as well, but I end up having to call pretty much every time I place an order because they will say that my order can’t be filled, or it says the order is submitted and then they don’t tell me that they didn’t fill it or why, and when a week goes by with no update on the order I have to call and talk to 4 different people to get it sorted out. The online ordering will not let me order my full amount of supplies because someone put in that I was only covered for a lesser amount, yet when i call they are somehow able to change it and order the full amount, but it doesn’t change the online ordering limit, so it doesn’t help for the next time. I have had several times where they started using an old miswritten prescription out of the blue that only covered 2 boxes of infusion sets for a 3 month period, and on top of that said it was written by my current endo and not the doctor that actually wrote it. No one knows what they are talking about for the most part. I am amazed anytime I hear people actually have no problems out of them.
I am thinking of changing my insurance to one I can go out of network so that I can order through ADW Diabetes. My experience with them with ordering some things out of pocket has been great. Even when they found that my insurance didn’t have them in network they were immensely helpful and even got the info from my insurance company on what options I actually had (which is only 2, Edgepark and North Coast Medical Supply, which I believe sells diabetic supplies under the name Advanced Diabetes Supply…both of which are known for horrid customer service and care), a question which every person I talked to on the customer service line for my insurance couldn’t seem to accurately answer.
I have been stuck with Edgepark this year as my only in network option for CGM supplies. I have had similar red-tapish issues with my first 2 reorders. Their “continu care” on line re ordering is not helpful at all. It seems to handle refills for sensors but not for transmitter.
However, today I had a new experience with them: a competent helpful person on Edgepark’s end of the phone. I kept him on the line and had him check the status of everything I could think of and he had all the answers…Since the OP asked for positive comments, thought I’d throw that one out there.
My preference would be to order direct from Dexcom but that is not an option if I want to have my health insurance cover the CGM supplies.
