Pump supplies part of Durable Medical Equipment?

General
1

Let me start by saying that I know I am lucky to have medical coverage and I am grateful because I know that many do not have it. However, today it feels like the way they do things is preventing me from getting the best healthcare that I can.

Anyway, here's the story:

My daughter had to upgrade her pump to the 7 series Minimed, so she gave me her old one. That's great because that saved me about $5000 out of pocket, right?

Well, I talked with Aetna today to see what their coverage was for the infusion sets, reservoirs, etc. Unfortunately, they consider the pump supplies to be DME as well, so they only cover 50% of my supplies AFTER the $2500 deductible. So basically, insurance doesn't cover anything because it would take me a year to get to $2500. I don't think i can afford $160+ per month in addition to $40 co pay for test strips, insulin, etc!!!

Is this common for insurance companies to classify pump supplies as DME? So frustrated!

2

Ours are classified as DME as well, and we pay 20% of the cost. It's pricey...

3

medcohealth changed pump supplies to DME in 2009, but I don't have a deductiblie and the supplies have the same copay as regular prescriptions.  

4

My insurance considers any supplies (pump, syringes, testing strips, etc.) DME.  After my deductible of $600 I pay 80%

5

That should be my insurance pays 80% and I pay 20%.

6

This is my biggest fear. I am being forced to go on a different plan from my employer, and I am so afraid I will not be able to afford to stay on my insulin pump!

7

This was actually a big factor in why I changed jobs.  I'm hoping this insurance will wok out better but who knows, I haven't been able to get above water and am considering going back to MDI again.