Gotta Love Those Insurance Companies

Just curious about something. How many of you out there had problems getting the insurance to cover your pump training after you received your pump?

It has taken me over 2 years to get my insurance company to say yes to me being on a pump. My husband’s company is self-insured so they had no choice. I went over the insurance company’s head. Now that I have the pump and I am having a hard time getting them to approve the training for the pump. The doctor wants to place me in the hospital for 23 hours to start the pump and boy are they really dragging there feet on that. How many of you out there did not have to stay in the hospital when you started your pump? Is having to stay in the hospital normal? Can I get my doctor to put me on the pump without a hospital stay? If I do not get placed in the hospital this week it may be the middle of December before I can be placed into the hospital because of everyone’s schedule.

I am so excited about finally getting the pump that it is a big let down having to wait 2 1/2 months before my pump actually gets insulin put into it.

The first insulin pump i had which was almost ten years ago they hospitalized me. My new pump i just got in August they had me come in for a two or three hour appointment to get me started. Then i had to email my numbers after a couple of days. I would defiantly see if they can set you up without a hospital stay. I had no issues when i started on my insulin pump.

I got my pump three years ago. The training was provided in my home by the company and lasted no more than two hours. In addition there was on-line training called “Pump School.”

It doesn’t surprise me that the insurer doesn’t want to pay for hospitalization since pump use is spreading and training is not that difficult. You may have a special situation though, so I would work on getting my doctor to go to bat for me and explain why hospitalization is required.

good luck,


Are there extenuating circumstances in your situation? I started pumping 8 years ago and never had to go in the hospital. I think that would have been a deal breaker for me and I would have stuck with MID, but don’t do that. You are excited about it. I wasn’t excited so much before I started. Now I would do anything to keep my pump. I’m sure your endo has a reason. Talk to him/her about your concerns and the insurance problems. Maybe he/she can help. Good luck!! Hope it works out soon.

I also had about a 2 hours training with a pump trainer at a diabetes education center. Then they loaded my pump with saline solution and I was to do EVERYTHING on the pump for two days (while still giving injections). When I went back, the trainer checked the history log to make sure that I did everything as I was supposed to, then we loaded the pump with insulin.

No one ever mentioned hospitalization. This short training helped, but most of what I learned came from:

  • reading the pump manual cover to cover
  • “Pumping Insulin” book by John Walsh (I highly recommend it!!!)
  • my pump company rep :slight_smile:

My very first pump (in 2000), the rep came to my home, trained me, and left me pumping happily with insulin (not saline). Every subsequent pump, I’ve just spent an hour or two with my CDE (diabetes educator) and made sure I knew how to program the settings. I’ve never heard of having to be hospitalized for pump training. That seems extraordinary to me. But, like others have said, your doctor may be considering extenuating circumstances…

I started on the pump on my own. I got the book Pumping Insulin when I made the decision to try to get a pump, took me 2 years to get it with my insurance, but I started it on my own the same day I got it. I figured all my settings out from reading the book. About a month after I got it, an independent CDE with Medtronic contacted me about meeting and doing training. My insurance had nothing to do with the training, the pump company set all that up.

Ditto on the didn’t have to get hospitalized. I met with the pump’s rep one evening and we got all set up right away - I was pumping by dinnertime.

Here’s a secret: the training is pretty straigthforwardly just a If you already have the pump, I would go ahead and familiarize yourself with how it works (if I recall correctly, the Cozmo comes with a tutorial on CD that will explain everything to you if you don’t want to slog through the manual). Someone else suggested John Walsh’s Pumping Insulin, a very helpful how-to guide for all things pump-related - get a copy and figure out your basals, boluses, corrections, etc. He provides walkthroughs on how to calculate this stuff based on your current insulin requirements, as well as suggestions on tweaking. Once you’ve done these two essentials, all you need to do is learn how to insert an infusion set. A diabetes educator or nurse practitioner should be able to walk you through this (hint: try calling Deltec directly for a meeting with your local pump rep - that’s how most people get hooked up).

It sounds like your doctor is being really overcautious. Don’t be afraid to take charge and get the ball rolling without him or her - and if they’re not willing to work with you at all on this, maybe a different doctor is in order.

The doctor will not prescribe insulin in a vial for me until I go into the hospital. My insulin is in pen form. I have read the manual and pumping insulin front to back. I am just thinking that the doctor is trying to be extra careful with me because of all of my highs and lows. I am just mad at the insurance company right now because if they were any slower with their decisions they would be going in reverse. You would think that if the insurance company approved the pump then they would approve all of the supplies, education, etc. that went along with the pump. That is just my opinion and I know right not it does not account for much.

My doctor wants me to start the pump as soon as the insurance company approves the hospital stay. Right now I am on pins and needles waiting for a phone call from my educator letting me know if I go into the hospital tomorrow morning or not. I am trying not to get my hopes up too high just to be let down again.

I went into meetings with the pump reps fully knowledgeable about the pumps that I was interested in. I even ask questions that the reps had to get back with me on because I knew more about their pumps than they did. I have read the manual, pumping insulin and the CD that came with the pump.

If I had enough insulin to try the pump on my own I think that I would go ahead and try it on my own. My insurance company is a real stickler about not having more than three days worth of medication on hand before they will refill the prescription again. I am just afraid that if I do use the insulin in the pump that I will not have enough until they are willing to refill the prescription.

So your insurance company won’t approve the stay, but your doctor is requiring it and he won’t give you a prescription for enough insulin to use your pump unless you do what he says. That’s really bizarre. If it were me I’d be looking for a new doctor.

Having said that, I can see why you might want to go along with his strategy. If you bounce around a lot BG-wise, he might be concerned that you need monitoring at the beginning. From the sounds of it, you’re really really ready. The only reason I can see him be justifiably concerned is if you have hypo unawareness and wouldn’t be able to turn off your pump or treat a low by yourself.

Is there any other doctor you go to that would be willing to write a scrip for the amount of insulin you need in your pump? If this doctor is going with the Cover Your ■■■ (as opposed to a treat the patient as quickly as possible) approach to medicine, maybe it’s worth going over his head.

(BTW, my frustration is on your behalf, not with you at all. You’re doing EVERYTHING right here - he’s getting in the way and keeping you from using your pump ASAP which can’t be good for your health. You deserve better than that. I hope it all works out for you, keep us posted!)


My frustration is not with my doctor it is with the insurance company. She can prescribe anything she wants to but it is up to the insurance company to decide whether or not they are willing to cover what is prescribed. I always thought that if a doctor prescribed it the insurance company would cover it. Wrong!!! They have the final say so as to what is covered and what is not covered.

I waited for this doctor for over a year because she is good. She is one of the best of the best in diabetes. You have to get a referral from a doctor and then wait at least six months for an appointment. While waiting for this doctor I saw others and just kept the appointment with her. I saw other specialist and got no where. I saw doctors that did not know how to turn on glucose meters. Ones that did not know how to read test results. Did not know what medicines did what and I am talking about diabetes medicines.

I will keep the doctor but I would love to fire the insurance company.

Boo insurance company!

At the moment I have the opposite problem. I just went to a new endo and was a bit underwhelmed by him. His practice seems to be mostly type IIs with not very much knowledge so a lot of what he does is explain very slowly and carefully what must be brand spanking new to most people - stuff that I’ve known for years. He doesn’t have very many folks on the pump and was very surprised by my Cozmo (his patients are all on Minimed). So I have a doctor who’s not very helpful and insurance that covers everything I need. Weird, huh?

I’m glad your doctor has your best interests in mind - too bad insurance companies don’t work the same way.

Sara I think that I would start looking for a new endo. I have been through 3 others before finding one that I clicked with. This one treats me as an intelligent person not someone who is stupid. Not all diabetics are stupid.

My doctor prefers Minimed also. I told my doctor why I wanted the Cozmo and she told me it was my choice in the long run. She is willing to learn anything for her patients. My doctor’s partners is on a pump so that is why she may know the benefits of a pump.

Have your doctors drawn you pictures so that you understand what they are saying? I sat through 15 hours of diabetic classes which included being entertained by the CDE drawing pictures for the class so that the we would understand how a diabetic should eat, what carbs are, what is a good fat, etc. When I went in for pump training the CDE also drew out pictures for me so I would remember how everything worked. I wanted to say something but I realize that they deal with people all day long who do not understand anything.

Wow I have been pumping 9 years and never went in the hospital. The pump trainer came to my house. Most recently we went to Chilies and had lunch! The trainer came about 2 days after I got the new pump. I am still not understanding why they want you in the hospital? Is there other medical issue’s going on? It really make no sense to me but I am sure there is something I don’t know. I asked my other pump friends they never heard of it as well so I am very curious could you post more about the hospital stay so I can understand?

Be well and be loved

I do have some other issues, high blood pressure, high cholesterol, allergies, etc. Nothing that I would think was really bad. I am thinking that because I have such large swings in my sugar levels is the reason for her wanting to put me into the hospital.

No pumping for me this week. Doctor left town because of a death in the family.

I know my New Years Resolution for 2009 will be to actually start pumping by the end of the year.

I, like Sarah S., have the opposite problem. My insurance company will cover my pump, supplies, training, etc. 100%. I won’t have a penny out of pocket for it. But, I can’t find a good endo in my area. I have tried every one around here. I live very rural. Therefore my choices are very limited. I have one more shot at it. I have an appointment with a new one that is about an hour drive from my home, but I couldn’t get in with him until Dec. 1. I want to try the Omnipod so bad I can’t stand it, but my current endo (Blah!!!) only supports MiniMed. That is the only one he knows anything about and will not learn about any others. Before I got the appointment with the new one I made sure he would support any pump I choose. He, too, prefers Minimed but knows that it is ultimately the patient’s choice. I hope and pray that he will be good for me. I have heard good things about him so…MAYBE!!!

I wish you the best of luck with the new endo. If you new endo is good then you will not mind the drive.

I live in a city that has a medical college in it. I live 5-10 minutes from the college and the hospital that they train at. You would think that we would have an over abundance of specialist but that is not the case. We are on a shortage of doctors because they are choosing to practice elsewhere in the country.

My endo wanted me to try the Omnipod and I said no because I could not choose what type of adhesive I used with pump. I am allergic to some adhesives and also latex.

well I am still unsure but I guess your doc knows best. I am swinger too.

35 to 550 and back again when I was on shots its a very hard way to live so I my heart goes out to you. I guess the only concern might be is Blood Pressure fluctuations once your BG starts to even out. I think your Blood pressure tends to be higher when your BG is higher as long as your well hydrated. Not sure though. Maybe they are watching to see if your blood pressure meds are going to need to be adjusted. I would ask though. Because the training outside the hospital is part of service and you will be able to get it without out of pocket expense. So I would make sure your doc really has a reason that is in your best interest and not that he or she just is not familiar with the hook up procedure.

You can also call your insurance company and ask them why your doctor requested you be in the hospital if there is a medical reason they should know about it and once they tell you ask them why they are taking so long to cover you since it cost them more for you to be in and out of the doc’s, ER and hospital with swinging sugars.

You have me curious as a cat waiting :slight_smile:
Be loved and be well