RebeccaS Posted March 23, 2016 Share Posted March 23, 2016 DD has type 1 diabetes. It's not well controlled at. all. It's not for lack of trying but hormones and her stress/anxiety make it extremely difficult to keep her in range. She uses a CGM and was on a pump, but we took a break from it for a while but we'd like to get her back on it. Last year we had amazing insurance that covered all her supplies 100%. This year we had to switch and we are now relying on her secondary insurance to pay the balance of what our primary won't pay. Her primary is not an issue at all. The secondary (through the state of OH) is taking forever. The medical supply company submitted the request on Feb. 9th. The fax sent on someone's desk until Mar. 3 when it was finally entered into the system. Now, it's going to take another 8-10 weeks from the 3rd for us to actually get approval, never mind the shipment of supplies. We rely on her CGM so heavily to help manage things. Particularly at night when she has the most unexpected extremes (highs or lows). Then I found out that even though I had started the process for the pump supplies, no one has any record of that actually happening. So, it'll be another month before that fax gets entered into the system and another 8-10 weeks for that... :smash: :banghead: :banghead: Quote Link to comment Share on other sites More sharing options...
mommybee Posted March 23, 2016 Share Posted March 23, 2016 (edited) I feel your frustration! It took two months and so many calls to get my sons supplies in the works thanks to a bunch of mix ups and then I found out our insurance now only pays 50% of supplies so a three month shipment cost us $257, that was for 3 boxes of sets and 3 boxes of cartridges....that was it. I couldn't believe how ridiculous that is. We used to have such great insurance and it just gets worse and worse every year. Edited March 23, 2016 by mommybee Quote Link to comment Share on other sites More sharing options...
Mothersweets Posted March 24, 2016 Share Posted March 24, 2016 I totally get it! My dd has type 1 and is also on a cgm and pump - supplies are incredibly expensive. I dread having to deal with our insurance co - it does seem to get more complicated and $$$ every year. Quote Link to comment Share on other sites More sharing options...
AmandaVT Posted March 24, 2016 Share Posted March 24, 2016 I'm so sorry!! I work with insurance companies for my job and my best advice is to call, every day. Keep calling. Be the squeaky wheel. It's not fun, but what I've found is that the bean counters in the insurance offices have a giant pile of paperwork to get through and if you call (and are nice), they'll find a way to move you to the top of the pile. I hope it goes through quickly!! 3 Quote Link to comment Share on other sites More sharing options...
Sara in AZ Posted March 24, 2016 Share Posted March 24, 2016 Hugs!!! The thought of losing his job and our insurance coverage for our Tyoe 1 keeps my husband awake at nights. So sorry you are dealing with this!! Quote Link to comment Share on other sites More sharing options...
SparklyUnicorn Posted March 24, 2016 Share Posted March 24, 2016 that's total bull 1 Quote Link to comment Share on other sites More sharing options...
Cz mama Posted March 25, 2016 Share Posted March 25, 2016 Im so sorry...My husband has had type 1 for 28 years...I call myself his 'secretary' and on days that I'm on the phone all day with insurance I remind him that his secretary needs a raise... :) 2 Quote Link to comment Share on other sites More sharing options...
Mom2Five Posted March 25, 2016 Share Posted March 25, 2016 Aww, Im sorry. I have issues as well. Can they put it through as urgent....my brain has shut down and I cant remember if that is the word or not that we had to use to try to get them to move it along faster. Quote Link to comment Share on other sites More sharing options...
sassenach Posted March 25, 2016 Share Posted March 25, 2016 Does she have a nurse case manager? With most insurance companies, you can request a NCM if you have a complicated case. I found this invaluable in getting through red tape. I even mailed our NCM a picture of my son. I made a point of learning how many kids she had and the names of her grandkids. I'm not even kidding. We had a season where we needed DS to get a very expensive and not usually covered treatment and I think the key was I had someone on the inside who had a personal connection to us. In your case, the state might not have anyone in that role, but if your primary does, they might be able to squeak along with you. Oh, even last year, I had a social worker in our GI office get DS a dental appointment that I had been calling about for 9 months with no luck. Social workers can be great advocates. (((Hugs)))) 2 Quote Link to comment Share on other sites More sharing options...
Murphy101 Posted March 26, 2016 Share Posted March 26, 2016 This is why we eventually didn't seek insurance anymore and just buy our insulin supplies from Canada and London. With insurance in the USA - $600+ every 3 months Without insurance from Canada or London - <$100 for 3 months. Exact same materials and quantity. Zero hassle. Quote Link to comment Share on other sites More sharing options...
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