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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As I mentioned in an earlier post, one of the benefits that made it cost-effective for me to go with the real healthcare (HSA) plan rather than the phony (HRA) plan is that my company is now covering "preventative" medicines at $0 copay. The formulary for these, as stated by CVS/Caremark (my pharmacy benefits provider), covers all test strips, lancets, and control solutions. I dutifully get my doctor to write up prescriptions for all of my testing needs, submit...