I just wanted to share my horror story of me trying to get a new insulin pump. Get it off my chest and see if anyone else has had this much trouble.
I have been on the Medtronic 512 for almost 6 years. It broke May 8th. Medtronic's immediately sent me a new one, I received it at 9 am May 10th, which was real comforting. They told me I could use it free for 3 months.
So I began trying to get the new Revel pump May 10 with the addition of CGM since I no longer feel low blood sugars. I notified my doctor and Medtronics and was assured it would all happen fairly easily. After a week I called Medtronics back, not having heard who the rep was who was covering my account and got a name. I called and left a message and still didn't hear back, so three days later I phoned and asked for a supervisor and had to leave another message, but at least the supervisor called me back and explained that the rep was out on training. So what, I wish I could delay my diabetes for training, but I couldn't. Then they told me that my Doctor had to fill out some paperwork. So I called my doctor and was told that was on top of his desk Apparently my calling stimulated and he finally filled out paperwork.
Next, ball back in Medtronics court, they didn't seem to do anything with the paperwork. I phoned my insurance company and they told me all that they needed was letter of medical necessitty from Medtronics. Medtronics tells me that they need to get that letter from my doctor. What the heck was that last wad of paper they had him fill out? Now I am waiting again for my doctor to fill out a letter of medical necessity for Medtronics to send to my insurance. Does this ever end?
Why does someone who has been using an insulin pump almost 6 years and has had infusion sets filled by prescription for the insurance company for said pump need a letter of medical necessity. Maybe I am missing something here. Maybe diabetes goes away over time? I would hope. Anyway, this has gone on for a month.
You're absolutely right - it is ridiculous, but it does go away, eventually, for a while.
When I got my pump, we got everything squared away, I started on the pump, and then two weeks later my mom got a phone call from Animas saying that our insurance company had denied the claim because I wasn't covered by them. It took more than three months for me to tell them that they had my birthday as four days after it actually is! THREE MONTHS. But at least I was wearing the pump all that time.
It sounds ridiculous to us who are diabetics and are on insulin pumps, but insurance companies have Standard Operating Procedures (SOP) just like the military and other large organizations. Ressons for these SOP policies help keep costs down and unnecessary procedures and equipment from being done.
While I do not always agree with these policies, they are there for a reason, and learning how to work the system is a part of living with D. My insurance company will only allow something like 100 test strips a month. My doctor may write the Rx for "Test 7 times a day" which works out to 210 test strips a month, but they will only allow the pharmacy to dispense 100 a month. I have to every year call the company, and have them fax my doctor an override form, call the doctor and inform them I must have this form filled out for them to dispense the correct number of test strips. It is a pain in my butt, my doctor does not feel she should have to fill out additional paperwork, but if I wan tthe strips it is the only way to get it done.
It sounds like Medtronic and your doctors office has dropped the ball on this, which is unfortunate for you. The CSR should have had an alternative VM greeting saying they were in a class and give you an option or tell you an additional ext to call to have your needs taken care of. Have you contacted the insurance company and talked with the DME or diabetes specialist they may have to find out what pumps they cover? I am unaware of any companies not covering MM pumps, but my insurance didn't cover One Touch Strips as generics last year, so I had to look at the Bayer and Accu Check products to find one to get strips for a $0 copay vs a $50 copay for the One Touch.
Another week, still no news on getting new insulin pump. This all started with me trying to get CGM back in March. Finally got approved for Dexcom in June. Then my pump broke and I decided to switch to Medtronic because it all works together. I am still waiting for a move on my doctor's part and Medtronic's part. It seems those two have it out for each other. My doctor pretty much exlusively uses Medtronics but hates their sales reps and has asked that they do not come to his office.. Medtronic reps fear my doctor and won't go to his office. Apparently the fax number medtronics has given my doctor is now outdated and they do not receive his fax of a letter of medical necessity. I am caught in some sort of bureaucratic hell between the two. This is ridiculous. If this ever get's cleared up I am attempting to get a new endo.
I have been verbally told by my insurance co that once they receive the letter of medical neccessity it would take less than a week for approval.
Just a heads up - I know lots of people who are unsatisfied with the medtronic CGM, saying it is inaccurate, it's sensors hurt, etc. YMMV. Sometimes I feel like a Dexcom rep cuz I love my Dex so much, but I really have had lots of conversations with people who, even on minimed pumps, dropped the minimed sensor and switched to dexcom (and a couple to navigator) for the increased accuracy and sensors that don't move around as much.
That is unfortunate that you have to wait so long for a new pump. I have an out of warranty 512 and got a call from Medtronics on Thurs. 5/20/10 asking if I wanted to get an upgrade, so I agreed since my deductible was met and our new year for insurance starts July 1. I got a phone call on Thurs. 5/27/10 from medtronics rep. saying that a fax had been sent on 5/25 to my doctor's office and if I could give them a call to ask that the paperwork would get completed. I sent my doctor's an email the next day and a message was sent back that someone had taken care of that already. With the holiday in there, I got the revel pump on Tues. June 1. I decided I wanted to go with blue instead of the smoke color, so I gave Medtronics a call around 6 P.M. and had a blue one on 6/2 at 10 A.M.. I am waiting for an upcoming appt. before starting the new one.
HALLELUJAH!!! My doctor has finally submitted the correct paperwork to Medtronics so that they can submit the request for the new pump and cgm to the insurance company. This began May11th and my doctor was so stubborn that no one could tell his office that they we're submitting the wrong info. CRAZY!!! I am in the search for a new Endo, which means I probably will need a new family practicioner too. This has been too much for me. I phoned the doctors office yesterday, quite upset and the nurse seemed like she was trying to throw it all back on me, as if it was my fault. COME-ON! It took me a month and a half to get them to send in the correct forms which I understand were all filled out, and just required the doctor's signature. THIS SHOULD NOT HAVE HAPPENED. I probably will receive the new pump and CGM next week.
Medtronics has been good to me, allowing me to use their loaner pump during this mess for free. And they are giving me 500 dollars for returning my old, broken pump. Plus their rep went and waited quite a long time at my doctor's office to get the correct paperwork into the doctor's hands. Julie from Medtronic's is the best. Thanks!
I had a problem with my last insurance company saying that my insurance didn't cover anything with pumps or the supplys. Come to find out the medical equipment coverage was thru UMR and any other supplies thru a pharmacy was covered by a different part of my insurance. I still hadn't been able to find anything out even though I had gone through the billions of calls to Medtronic, my insurance company, and my doctor. I finally called the local Medtronic rep for my area to complain and he gave me the direct number for someone in the billing dept. She was extremely helpful with investigating the issue. She called my back the next day to let me know what the coverage would be and what my out of pocket was. I have learned that if I have any issues and calling Medtronic first doesn't help I will call the rep. It seems like he knows all the back line phone numbers to get things done quicker.