O.k. So as you can tell, I was playing around with blogger today. I know the picture is huge at the top...I'm still trying to figure that out.
I still have not figured out coverage for a replacement pump.
My doctor wrote a letter of medical necessity. I talked to the corporate health benefits people. They told me that there was NO WAY that a replacement would be covered. The only exception would be if my current pump breaks. Then, it would be considered “medically necessary.”
Since I was dealing with the insurance company about the pump situation, I decided to bring up the glucagon issue again. I was transferred between 5 different people. Finally, I talked to the “caseworker” assigned to my claim. (let’s just call her Mrs. Notveryhelpful) I asked why my appeal never was approved. Mrs. N said that she just happened to be working on my claim the day that we talked. (hmmmm, I find that very hard to believe. That would be one hell of a coincidence!) She said that it was rejected. Again, I brought up the fact that it was covered last year. She was surprised by that. She jiggled around on her computer for a couple minutes and then said, “why, you’re right. It was covered last year, and should be covered now. It looks as though your pharmacist just coded it wrong. Tell them to submit it as an emergency kit.” I called the pharmacy and asked them to try resubmitting it as an emergency kit. The pharmacist said that she wasn’t sure how to do that. I gave her Mrs. N’s direct number and told them to call her directly. An hour later I received a call from the pharmacy telling me that the glucagon would be covered and ready for pickup in an hour.
I guess that I missed d blog day. I so love reading blogs of people who share this dam diabetes. And thanks to those of you who reply here, sharing kind words and/or giving me information. ☺
By the way... Happy World Diabetes Day.
The picture above is from last night. I poked my finger to test, and blood came out of an old poke hole. I hate when that happens. It makes me mad that I poked if I could have just squeezed my finger to get a drop. Of course you can see Dixie in the background.
11 comments:
That happens to O sometimes. She thinks it's a riot. Of course, she's only 13...and easily amused.
I'm glad they covered the glucagon. Insurance companies can drive you to drink sometimes, I swear. The hoops you have to jump thru. So aggravating.
I like the new layout! Even with the big photo of Dixie at the top.
Thanks for the virtual hug, I think work and school are really starting to get to me. I am so glad that there is this online community!
I am not sure about your insurance situation and the pump coverage. But it sounds really crappy of the company to not let you get another pump, what if it WERE to break, do they realize how long it would take to file the paperwork to get the new one versus allowing a new one now and letting it be covered under warranty? A replacement would be a breeze then if it were to break. I suppose they don't and that is just frustrating.
Oh, I was checking out, to fulfill my own curiosity, how service dogs for diabetes works and found an article about you and Dixie! I got all excited and was like "I met her and Dixie and read her blog!" The article was older, and in true me fashion I can't recall the site I found it on, but hey, thought you'd be amused none the less.
Thanks again Molly and good luck with insurance and the pump scandal.
I like the layout.
I enjoy reading all the blogs, too.
Thanks for your lovely photo of snow! yay! you are awesome. I hope I can meet you and that sweet Dixie someday when I'm back in the Midwest.
Molly, I loved the picture of Dixie up at the top of your blog. Can I tell you that I kind of have trouble reading the medium blue text against the dar blue text. Maybe there are others like me?! Concerning the replacement pump - my fingers are crossed, and I am glad that you finally have the glucagon covered.
Julia, if you get this meassage, I am having trouble opening your blog. It gets locked. If I manage to open it, comments do not work. I thought you might like to know.
Major- It is amusing sometimes..I agree with O :-)
Amber - Glad that you're feeling a little better. Funny about finding the article. I think that people google "diabetes service dogs" and get that article, which is why I get emails from curious people.
Amylia- So glad that you liked the snow picture that I sent you!
Chrissie- O.k, I've changed the font size and color. Let me know what you think of it now. thanks for the feedback.
Hey Molly!
So glad to hear that you got your glucagon covered. But doesn't it just royally PISS YOU OFF that it caused you all that headache simply because it was coded wrong? This is a perfect example of the "hoop theory" I've talked about. I'm going to blog about it soon, and you'll see what I mean.
And I hate to think what would have happened if you actually would have NEEDED it. I tell you what, it just irks the heck out of me.
And on your pump, your insurance company is telling you that if you "happen" to smash your pump to bits in the parking lot then they would pay for it?
I just don't get it sometimes.
I had the "poke here, blood there" thing happen to me before too. Like O, I get a kick out of it sometimes!
We need to get everyone together for another MN Blogger meet up! Maybe after the holidays or something.
Take care!
Oh, lovely! It was the blue text on blue background which was difficult! Thank you!
Molly
I wonder whether insurance company would be held liable if the out of warranty pump broke and you needed emergency treatment as a result.
Maybe you should talk with a lawyer at the insurance company and ask them if they have insurance to cover something like that. :-)
As insurance companies only seem to care about money, I say hit them where it hurts.
Hi Molly. Hi Dixie. (maybe snow this week?......)
Scott- I'll look forward to your upcoming blog. And...I'd be interested in another get together!
Bernard- I'm in the appeal process, with letters from my endo. Hoping for a positive outcome. Thanks for the ideas!
MN Nice- I drove over to my dad's today for lunch. It snowed on my way home... big, fat, wet flakes that could have been rain. I think it's coming soon. Dixie loves snow and can't wait!!!
Hi Molly,
I tagged you. See my post.
Colleen
PS - love the pic of Dixie!
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