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Question:

From McPherson, Kansas, USA:

I'm a teenager with type 1 diabetes. I have had an insulin pump for two years now, and I am on my ninth pump of the same brand right now, so it appears they're continually going bad. A nurse at my doctors contacted the company, and they sent me the newest version, but I don't feel very comfortable with it. I would like to switch brands, but I don't know if my insurance will let me. Do you have any insight as to whether or not my insurance company will let me switch brands if I have a "working" pump?

Answer:

It is important to feel confident with your insulin pump, but your insurance company's rules may make it difficult to switch brands. Many insurance companies require two or more years to pass before they will pay for another pump. Here are some suggestions:

  1. Learn all you can about the pump you would really like to use. What features does it have that your present pump lacks? Sometimes an insurance company will agree to purchase a different brand when the features provide more safety, more accuracy, less potential for error, etc.
  2. Ask your physician to write a letter of necessity highlighting the features that will make the new pump a better choice for you. The letter should remind the insurance company that you are an adolescent and that the features will make pump therapy more safe or effective for you.
  3. Work with a pump company or distributor that will help with the insurance issues.

BS

Additional comments from Jane Seley, diabetes nurse specialist:

Usually the insurance companies won't pay for another pump for four years, but it sounds like you have extenuating circumstances. You could contact another company and ask them if they will help you write a strong letter to your insurance company.

JS

DTQ-20030212101312
Original posting 11 Jun 2003
Posted to Insulin Pumps and Insurance/Costs

  
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Last Updated: Tuesday April 06, 2010 15:09:46
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