No, they will not eat the cost. MOST Anthem plans have a DME cap of $3000 annually. Here’s what you need to find out. You need to find out if you have a cap on your durable medical equipment. To do this you have to call Anthem. Most likely you will have around a $3000 cap per year. This is not the same for all medial plans so this is why you have to call Anthem. So what will happen is Anthem will pay $3000, then you will have to pay the remainder to MM. MM will let you bill it out, but…
Did Anthem receive a bill for $6500? according to your EOB? If it did, and they only paid $3000 or a little less, the rest of that cost will be transferred to you.
The EOB (explanation of benefits) tells you what your insurance covered. You won’t owe anything on that,because Anthem is not billing you the pump. You will get something from MM. Insurances are sneaky. Usually what happens is the insurance pays a part and you either pay the remainder or if you have a deductible you pay that. It’s kinda tricky and each plan regardless of what state you are in is different. Sometimes, if you have a deductible, your insurance pays whatever it will, and you pay the deductible and that’s that. Other times, even with a deductible, you may end up paying the entire balance. For me. I have a $700 deductible but I would still have to pay the remainder of the balance to get my pump.
Also- are you trading in your Animas Pump- because you may get a credit for that. If you are, that will take some off your total, but if you aren’t you will still have the WHOLE thing to take care of.
Really the only way to know is to call your insurance company. Their number should be on the back of your insurance card. If you tell me your state, I might be able to give you more info on your plan. If you do call your insurance company, make sure you don’t get off the phone until you understand what they are telling you. I work with medical insurances for a living and when I called for info on MY plan, I got flustered. So keep asking until you are confident you understand!!! Good luck!