T2 Pumping?

There is a time when it is very difficult for a Type 2 to get a pump…when on Medicare. My Animas pump went out of warranty, no problem as my insurance will cover a pump, even for Type 2, if doctor prescribes it. The problem is that a Medicare denial is needed, simple denial means that my secondary (not supplemental) will cover the cost of pump. But to get a Medicare denial, the pump distributor needs to make a claim to Medicare. However, they will not make a claim to Medicare for anyone who would be denied by Medicare…catch 22.

I was near hysteria as my Animas had begun to malfunction on occasion. I was saved by a ‘bad’ result of C-peptide test. As I not insulin resistant, but have a pancreas not making much insulin, my test result was low enough for Medicare coverage. I was lucky, but most Type 2s don’t have a low C-peptide as they are making a lot of insulin to cover for the insulin resistance. This really presents a problem for pump-using Type 2s who use a pump but go on Medicare.

At any rate, hope I have explained it.

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I have been pumping for 4.25 years. I had been on insulin injections for 25-30 years. When I started with a new endocrinologist she was concerned about the volatility in my numbers so she adjusted my diet, enhanced carb counting and knowledge about adjusting doses. After that proved not to change the fluctuations, she wrote a letter of medical necessity and the insurance agreed. The pump has made a huge difference in my numbers and quality of life. The pump can administer very small amounts of insulin as well as multiple basal settings throughout the day to even out the peaks/valleys.

Getting a pump under medicare is a much different issue because they require that your cpeptide test is extremely low, almost non-existent. If you can get a pump before Mediare they will cover the supplies for a pre-existing pump.