Hi!
I'm moving to States soon and I am currently using a Medtronic Minimed 722 pump in Spain . I don't know if someone could advise me about health insurances that could cover pump and supplies, and which criteria should I meet or how to proceed.
At the beginning I will subscribe to my wife's health insurance, but it doesn't cover anything related to pumps.
Thank you!
Well, insurance varies from provider to provider, state to state , etc, but if you're asking for insurance experiences? I just got a medtronic Minimed 530g and I have United Healthcare , they covered the pump and cgm transmitter 90% itself , and there wasn't really anything special for me. I just had to send my logs from January to last week and I didn't have to really meet any other criteria? I haven't seen anything about the supplies for it but I have a ton of supplies in this big box in my living room. As for keeping your current pump I don't think there should be something special to do it they just have to know you have a pump on mine to get more supplies from what I understand.
I think the best thing I can tell you though? Talk to your doctor and diabetes educator when you get here and see what they can tell you, then call the people at medtronic and have a little chit chat with them about what they can tell you about moving over here and dealing with your supplies?
Thank you very much!
I guess it's hard till I get to deal with everything, but it was really helpful :-)
Jorge
I use Cigna, but Sensorium is right -- it's different state to state.
I suggest you find an insurance policy sales person. They can help you find a policy and they're not usually only selling one company's policies. Also, you don't pay for them, they get paid by the insurance company. Whatever policy you go with, that's the company that pays them. Tell them what supplies you need and want, what doctors you want, and it's their job to research it all for you.
I have BCBS but there's different plans, etc. My pump was like 7500 but I paid 300 for it.
My Blue Shield of California covers my pump with a 50% copay. As you are probably aware, health insurance in the States is a mixed bag. A pump and the supplies are usually treated as Durable Medical Equipment (DME) and you pay a DME copay that depending on your insurance plan will be anywhere from 0% to 50%, with 20-30% being pretty common. Somewhere in the insurance booklet there is usually a line describing what they cover diabetes-wise except that it won't always list pumps because they are considered DME. You may want to consult the human resources liaison of your wife's employer and they can walk you through it.
hey churi2k, i was wondering if you got your pump thru seguridad social. i am t1d for two years here in sevilla and my endo is happy having me on mdi. i know it may be the crisis, but did you get yours a while back? any hoops you had to jump through?
I live in Madrid right now. Actually it was my endo directly who suggested me the idea, mainly because I had some trouble with sudden hipos and she thought my profile fitted the needs to use a pump. I started more than 3 years ago, but I can say the criteria to receive a pump completely depends on the Comunidad Autónoma, and even depending on the hospital. Unfortunately this year it seems the budget has been dramatically reduced, and some hospitals in Madrid don't even have a single one.
Good luck!
Jorge
sometimes the supplies are covered under drug coverage.
thanks, i was looking at the boe for laws and prerequisites for a pump and ive gotta have a high a1c and/or lots of hypos-ugh!
good luck in the states. im from new york, but havent lived there for quite a while. my friend is on a pump in ga. and she has quite a high deductible, having to shell out the bucks before her insurance kicks in.