Can someone please help up? My husband and I are falling behind on the bills and I don't know what to do. My daughter uses an animas pump. We receive a little financial aid through them but it's not much. I have tried program after program (including all listed on tudiabetes.org) but we have private insurance so we don't qualify for anything. Our insurance has a $3000/person deductible and doesn't pay for any pump supplies at all. My insurance agent appealed and we lost. I'm sorry for whining but I just don't know what to do. Does anyone know of any programs that could help us? I've already contacted the JDRF and ADA but they didn't have anything either because we have insurance. I've also contacted DHS but I was told that they couldn't help unless we quit our jobs or lost our insurance. Any ideas?
Hi My Name is Beth call Me 315-405-6192
I dont know what it is called and dont know if its just a Michigan thing. But when my son was diagnosed, they gave us paperwork to fill out for an insurance that was specific for children with diseases such as diabetes. Anyone could get it regardless of your own insurance, the only thing was it was based on your income as to how much you had to pay each month. Some people qualified for free and the monthly cost went up depending on income. We didnt take the insurance because our medical coverage is great and our out of pocket expense each month is way lower then what we would have had to pay monthly for the insurance. Test strips, lancets and all our pump supplies are considered durable medical and covered 100%. We only pay a copay on the insulin for the pump. This insurance I am talking about would have cost us over 100 dollars a month based on income. So it didnt benefit us. From what I understand, this insurance covers anything your own insurance doesnt cover.
Have you tried Medicaid/FAMIS? They are income based government programs that can often assist if you meet a certain criteria. Maybe shop around with different carriers as well.
We have private insurance as well, except with a 5000 deductble, but since my son hasn’t had a a1c above 7, they won’t cover a pump, fortunately th pharmacy benefit cover 2000, but that lefted us paying another 2500 out of pocket just for his insuln and supplies this past year. It would be nice to have some help with this. I try not to think about it too much, it worries me is that thi is a life long thing for my son. Sometimes it just makes me want to cry.
Have you considered removing your daughter from your insurance? Perhaps then you may qualify for goverrnment aid.
I will be in the same scenario at the end of this year. Let me know what you find out as I am on a pump and Cobra will not be an adoption. I was told I could put my daughter on LAChip which is a Louisiana based Government plan.
It really sucks having a medical condition and needing insurance! Good luck.
Please e-mail me at ferghouse at yahoo dot com so I can get your address to send you something.
Angie Please call me I lost your Phone number 315-405-6192 Beth
I am in the process of applying for Medicaid. Apparently, there is a program that will cover a child if they have a disability. Our income does not qualify us for regular medicaid but because of the Diabetes, I could get him covered under this. We have BCBS for him so Medicaid will act as the secondary. Good luck to you.
Hello Angie. What State do you live in? I live in PA and even though my T1 son has insurance through my husbands work he gets free insurance from the state. He was diagnosed 9-26-2010 and is now pumping and we have not paid a dime yet. It is only certain states that offer this insurance for children with chronic illnesses.... let me know if you need any help with this.
I know this is not optimal, but have you asked your insurance company if they have coverage for any other pump?
That is just not fair, what good is insurance if it doesn’t cover needs such as these!
My insurance will only pay for a pump once every four years so right now that’s not an option
Did they approve the animas and cover it originally?
They do approve Animas. The problem is that we have a $3000 per person deductible and the have to pay 30% after that is met.
Did you buy this private insurance or is it from an employer? If you bought it - get rid of it and get a better policy. Even if it costs $2k more a year it beats the $3k deducitble and 30% coinsurance
Most employers are going towards this type of insurance. My husband works for a large bank that had always had excellent, but pricey insurance through Aetna with options for cheaper PPOs, etc but now they have switched everyone to "Preventatve Plans" from Cigna and United Healthcare. They give incentives through an insurance account for checkups, colonoscopies, mammograms, etc. so that they do not cost anything but anything else is a "shared cost" after a large deductible.
The sad thing is that the per month cost is only slightly less than the expensive plan so not only are we paying $700+ per month for insurance, we also are paying the $3000 deductible before insurance pays 80%.