Managing Diabetes, Insurance, and Appeals
The cost of diabetes, insurance coverage, and overall management care is rising every year, and paying for supplies can really take a toll on your wallet. Sometimes just having health insurance isn't enough to cover maintenance costs. With the cost of health insurance rising every day, devices and treatment methods are becoming more expensive and diabetes insurance denials more common. But we have some tips to help you appeal denials and get the most out of your health insurance buck.
Before You Apply For Approval:
- Prior to applying for additional supplies, devices, or treatments, read through your insurance policy and check for any clauses about "pre-existing conditions," chronic illness care, "durable medical equipment" and "maintenance drugs."
- Talk with your human resources representative at your company for guidance on how to apply for approval.
- Contact your health insurance company and confirm the correct procedure for applying for coverage. Be sure to send your request in writing to the correct person or department.
If You Are Denied:
- Call your health insurer and find out why your claim was denied. Take note of the date you called, the representative's name, and their comments.
- If your denial letter gives vague reasons for denial, ask for further specifics in writing.
- Ask for a copy of your health insurance company's Evidence of Coverage or Certificate of Coverage, which will outline the full benefits of your insurance plan.
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I no longer wear an insulin pump. Nor do I wear a CGM. I wish the latter were different, as I think a CGM would be quite useful, but the welts that it leaves on my skin - in spite of multiple efforts to fight that welts - are just unacceptable. I am, however, still interested in when people remove their pumps and why. I've seen some recent discussion around folks being asked to remove their pump for mammogram procedure, so I figured I'd ask around the hospital I work to...