Just curious which insurance plans are covering the Tandem T:Slim so far.
I have United Healthcare, and they are still not covering it. According to the sales rep for my area, some UHC plans they can work with...but unfortunately, they have no 'out of network' options to try with my plan(EPO).
My pump warranty is up, so I am just starting my look. Not in a rush to be married to a new pump the next four years. The T:Slim is the only thing on the market that looks exciting. Of course, UHC says it is too new.
I am in the same exact boat! My UHC EPO plan doesn't have 'out of network' coverage for durable medical equipment, but after some digging around with UHC they told me I could get a gap exception and the t:slim would be covered. I'll keep you updated on how the process goes :)
Oh yes, will you please keep me updated on that! Are you trying to get it covered right now? What is a 'gap exception'? If I were to call UHC and say that...would they know?
Also, how will it work for your supplies, if it is covered? Sorry, so many question! You gave me hope LOL!!
I definitely will keep you up to date. I'm currently trying to get it covered, and from what I understand a gap exception is what is generated by your physician when there is no other available pump or piece of medical equipment that can meet a certain necessary medical requirement. I'm not entirely sure about supply coverage but I will be sure to ask and find out!
I have the tSlim and am on Aetna. Tandem is not an approved vendor, but they helped connect me to an approved Aetna distributor to cover the pump. Tandem was able to identify an eligible vendor in just a few weeks....pump is definitely worth the extra effort.
Mikey, thanks for your help! I'm glad to see that you were able to get you t:slim covered! Do you know if Tandem covered it through the out of network reimbursement program they have setup? Also how does supply coverage work out?
I have a local to me HMO called CDPHP, or Capital District Physicians' Health Plan. It will cover the t:slim but it had to have an existing distribution contract with the distributor. They do NOT have a distribution contract with Tandem so Tandem turned my sale over to Liberty Medical, who does have a distribution plan with my insurer. My pump shipped yesterday and I'm now awaiting its arrival.
I simply applied to Tandem and Tandem did the leg work to work this out, then Liberty did the legwork to get all the paperwork and approvals.
Sorry for delay in response. I am not covered through Tandem....Tandem found an in-network approved medical distributor for aetna (Edward HEalth) and they provided the pump and refills on my insets and cartridges....so it is all considered in-network.
Fill out the patient form and a tandem rep will figure out coverage for you.
Hi Danielle - I pay for my own Insurance since I'm self employed. I was approved for PCIP. Pre-existing Condition Insurance Plan. I had to be denied insurance because of my condition as well as have no insurance for 6 months. I covered my MDI for those 6 months. I applied for the Pump in Feb with Tandem. They did all the work. And after showing 30 days of BS values I was approved for the pump. The only issue is that I have a $2000 medical deductible. And PCIP covers only 70% after that. But I saved up just for this anyway. And Tandem will do payments if I request. Good luck and hope your one of us... one of us... one of us... hahaha
