Living with Diabetes and Lapband

I'm on a new plan and I was paying about $230 a month on prescriptions.  Now I am paying $436.  On my old plan, I was paying about $500 a month for the plan, now, about $250.

My co-pay for my insulin pump supplies is double.  It will be interesting to see when I meet my out of pocket expenses.

Of course, the costs don't include pump supplies, doctor's copays, etc., so I am definately paying more for health care.  I almost feel like my whole salary is being eaten up by the health care costs.

UHC claims that their mail order service might save me money but they can't guarantee it.  I really do like Pill Pack so they get to keep my business.

Fun stuff, and I still don't know if my sensors are covered. 

New job is still kicking my butt, but since I have a much younger co-worker that seems to have even less energy at the end of the day, I'm not too worried.  Enjoying it.

So I now have a "normal" insurance policy.  For years, I paid over $500 a month more to get a premium health insurance policy.  Now I am paying half as much through United Health Care.

It seems out of pocket is about twice as much.  Under $500 for pump supplies over a three month period, when I paid until $300 before. 

The most irritating thing is that I keep getting contacted by the insurance companies from my old job. Yes, companies, as they changed insurance companies.  Both think I am still getting coverage.

Of course, there are claims still trickling in and that's fine.

Last week I talked with Medtronics and they said, you were denied coverage because of your diagnosis.  I told them I wanted to see about an override, and they said I would have to talk with the insurance company.

I wasn't up for it, so waited until Monday. 

The reason I was denied?  Medtronics had submitted a 90 day claim and they only do 31 day claims.  I get that.  When I got my CPAP, it was a rental for the first year or so, because there are a lot of people who can't tolerate it. 

So I called Medtronics back and explained it.

Questions?

Why didn't Medtronics look at the claim denial and figure it out on their own?

I'm also wondering if they even processed the claim on the supplies -- they sent me a pump once without getting coverage.

<sigh>

The only type of work left to you is a stressful, working at a desk job.

Your arthritis means that you cannot do any job involving a lot of standing or walking.

You need the Continuous Glucose sensors because you are hypoglycemic unaware.

Insurance won't cover because you are overweight, thus you have to be Type 2.

You have been pumping insulin because that is the only way you even maintain weight. Multiple daily injections and basal insulin made you roller coaster.

The good news, they will pay for the supplies but Medtronics doesn't want to go for the overide.

You could do the sensors out of pocket but it is somewhere around $500 a month, about a fourth of your take home.

Another option is disability, about 2/3 of your old take home. It would be ironic if that company would cover the sensors.

Of course, I am lucky, I have Dulce. She is back working part time, getting ready to go full time. But that is a lot of work.

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