Live Your Best Life With Rewards for Good. Start Earning Reward Points Now. Get Started Now!

Reply
Conversationalist

Re: diabetes care and BC/ bleep

472 Views
Message 1 of 7

Medicare actually has really good coverage for Diabetes. My dad's supplement pays for his supplies and I'm pretty sure he doesn't spend anything else except for his med copays and he gets those at the VA. I found this article that might help you: Medicare and Diabetes

 

 

Report Inappropriate Content
Info Seeker

Re: diabetes care and BC/ bleep

2,365 Views
Message 2 of 7

Contact CVS/Caremark as they are partnered with Blue Cross/Blue Shield.  My wife's diabetic supplies for 3 months cost us under $100.00.

Report Inappropriate Content
Valued Social Butterfly

Re: diabetes care and BC/ bleep

3,150 Views
Message 3 of 7

rs484,  have a couple of ideas.  Most insurance plans do cover these insulin pumps under the Durable Medical Equipment (DME) portion of policy. 

 

#1,  I see where the company manufacturing the Omnipod brand is switching over to a mew model.  That may be part of the problem with BCBS,   paperwork mixup during the changeover.   

 

https://www.myomnipod.com/about-omnipod/faqs/

 

#2   other thought I had  -  judging from comments on other blogs  -  BSBC covers this under the PPO function -  meaning ,  you must use a provider for the pump and supplies that is on BCBS PPO list.   Could be,  the company that makes the Omnipod has for some reason been dropped off their list of approved providers.   (?)   Just guessing,  but that might explain why you were first told it was covered,  then it all changed later when the provider list dropped Omnipod.   Read this re:  Texas BCBS PPO plan coverage for these pumps:

 

https://connect.bcbstx.com/ask-bcbstx/f/8/t/54

 

Definitely look into that possibility,  as your mother-in-law might be able to switch to another brand that is just as good as what she has been using.  Surely,  if the Omnipod company was dropped,  other DME providers must be on the Blues list to choose from.   

 

Don't sell the house!    LOL.   I really think this is a temp problem that has a solution. 

 

Let us know

Report Inappropriate Content
Valued Social Butterfly

Re: diabetes care and BC/ bleep

3,170 Views
Message 4 of 7

Is this Blue Cross Medicare supplement of some sort (Medigap or Part C or retiree insurance) or individually purchased Blue Cross insurance for someone under 65. Different forms of Medicare pay for insulin pumps depending -- as with everything related to Medicare -- on "medical necessity." But it is unclear whether this is Medicare related?

(The basic rule for everything no matter what your answer is that it never matters what anyone "said." The only thing that matters is what is printed in the policy. However if this is Medicare related and someone misrepresented the policy, there might be some recourse related to fraud through Medicare. If not, there might be recourse through a state Insurance Department or Consumer Affairs department)

Report Inappropriate Content
Info Seeker

Re: diabetes care and BC/ bleep

3,181 Views
Message 5 of 7

Hi

They will only cover antiquated techniques like needles but nothing toward the insulin pump materials which determine the proper dosage and tells what needs to be administered. The cost of supplies to maintain the pump is about $800 a month.

Thanks.

Report Inappropriate Content
Trusted Social Butterfly

Re: diabetes care and BC/ bleep

3,188 Views
Message 6 of 7

Are they not covering anything, or are the supplies subject to a deductible or co-pay?


Just think. The world was built by the lowest bidder.
Report Inappropriate Content
Info Seeker

diabetes care and BC/ bleep

3,201 Views
Message 7 of 7

My mother-in-law re- signed up with Blue Cross/Blue Shield as they said they would continue to supply her OmniPod insulin supply pump. They have now reneged and the cost of the pump supplies will force her to sell her house. BC/ bleep claims to know nothing about it and has denied further coverage. Does anyone know any way to deal with this? Any help would be appreciated.

Report Inappropriate Content
Announcements
Prepare to Care: A Resource Guide for Families download this free guide developed by AARP to help make caregiving more manageable. It includes information on how to have vital conversations with older family members, organize important documents, assess your loved one's needs and locate important resources.
Top Kudoed Authors