Does anyone have experience getting an insulin pump on the federal BCBS plan? I have the more expensive plan (whichever one that is) and am looking at getting a minimed revel. Any experience out there? Minimed did not anticipate any trouble, so long as I had a doctor’s rx. Did your doctor need to submit labwork? Additional documentation? Just trying to get an idea of what they would be looking for.
I have BCBS fed. but switched to it after receiving my pump through another insurer. However there were no problems with them continuing to cover my supplies after switching. no additional paperwork or questions asked. I’ve always had pretty good service with them so I would suspect they won’t give you too much trouble outside the normal criteria. Good Luck
Do you know what the “normal” criteria are? Other than having a diagnosis of diabetes and a physician’s prescription?
a Dx, physician letter, submitted some bg logs for a month from what I remember. I have had my pump for 2 years and mine is Animas not MM so it may vary a little.
If you are a type 1 you won’t likely have any issues. A Type 2 might require more documentation.
According to your profile you are a recently diagnosed T1. I suspect BCBS is wondering about going on the pump so quickly. While the pump perhaps should be standard treatment for T1, it isn’t yet. I got my first pump while on fed BC in 2001. I had diabetes since 1982 though, and I had no difficulty getting it approved. That is why I have kept BC standard for many, many years. It usually is good about paying for meds and supplies and has always worked for me. It costs more, for sure, but it has been important for me.
You may want to get the tests to verify that you are T1, if you haven’t yet. And the pump company usually deals with the insurance and getting the doc letter. Is the pump rep handling your pump request? I would not attempt it for myself.
And, as Jessica said, collect your BG records for as long as BCBS now requires. Check their criteria and collect all the paperwork but let the rep handle the process–at least that is what I would do.
Dog lady…Got a minimed with bc/bs Fed last year. Doctor took care of all the paperwork. Your doc will need to submit labwork results and BG tracking will help as a prerequisite specially if its your first pump. I get my insulin with MEDCO mail order process. I get 10 viles quarterly for $70 (copay). It’s the cheapest I’ve found. I was buying them through CVS at $65 a pop. I get my pump supplies from Liberty Medical…about $120 a quarter as well. GOOD LUCK
I have fed bcbs but i have the lower option. With the higher option you will be responsible for 20% after the adjustement. I had to go through a supplier, chose liberty, and I had the pump within a few days. Liberty got all the paperwork they needed from the doctor, I didnt have to do anything other than order it. With the low option i had to pay 30% after the adjust ment which worked out to be about $1300 for the Ping. BCBS never questioned everything, it was really smooth. Oh and BTW this was just a few months ago, I got my pump in Dec 2010.
i’m jealous - i get 15 vials from medco for $1250! was that 70 each or 70 for all ten?
Anybody wonder why the uproar about federal benefits while the country is going broke?
Do you know if BCBS requested anything other than a certificate of medical necessity from your doc (i.e., bloodwork results, logbooks, etc)?
Not sure what you’re getting at exactly. The federal government is able to offer “good” health insurance benefits because the risk pool is huge (i.e., lots of federal workers sharing the costs). That is, you have lots of young, healthy workers offsetting the costs for people who need more substantial health care. We all pay premiums (not insignificant premiums I might add, but lower than what many other people pay). The larger any risk pool, the better the deals. This applies to large, private companies as well.
As for the country going broke…well, there are lots of reasons behind that. One of which is health care and it has nothing to do with the health care provided to federal employees. Rather, it has to do with medicare, medicaid, and the large portion of uncompensated care we are all covering (uncompensated care is the care provided in hospitals to people without insurance, who often wait until they are REALLY sick to seek out care or who use ERs as their primary health care delivery system). We all pay for that in the end.
as far as i know they did not request anything other than the letter.
That’s good…Liberty Medical didn’t think anything additional would be needed, but I just wanted to check. We shall see. Keeping my fingers crossed!
I have BCBS of Arizona and I got my pump from minimed 2 years ago, they asked for bg logs and some paperwork from my Dr. along with some blood test to prove I was a type 1 and they didn’t give a hard time it took probably a couple months and that was it.
Good luck, it is very exciting!!