Wednesday, November 22, 2006

Well, some bad news. MM talked to my insurance company and got several different stories, but finally they were able to determine that my coverage...sucks. Basically, they only cover Durable Medical Equipment at 50% and there's a $2k DME annual cap.

So this means that if I could get the pump this year I'd be paying $2800 and none of my supplies would be covered for the rest of the year. Then next year the supplies would be covered at 50% until I reached the cap. She said this sucky coverage was specific to the COBRA plan (previously DME was covered at 80%) and was chosen by the company. So the company *lied* to us when they told us we would be extending the same coverage that we already had. I'd be less annoyed if we weren't paying close to $900 per month for COBRA.

I said I was still willing to do it, so she sent me the documents and the payment plan information, which is *very* reasonable. I'm not sure yet if we'll need it since J. just got a great job offer. Of course, I still have to get samples from the rep so that I can find out if any of this is even doable. I think if it works it is worth the expense.

The next step is getting my new endo to sign the papers (they all said she was great) and getting referred to the Joslin clinic for training.

2 comments:

Megan said...

That stinks. So sorry it's not working out well. Hopefully you will figure something out soon. I know you are really excited about the idea of pumping.

Lili said...

Thank you, Megan. I think we'll be able to swing it. I guess it doesn't seem so bad since we're used to paying tons of money for healthcare already. I just hope I can get everything to go through by the end of the year.

I am certainly looking forward to not having to take 7-10 injections a day to have the control I need. I do it, but that doesn't mean that it's always easy. I am a little freaked out about the idea of wearing something that costs $6000, though. I mean, my shoes were $20...