Skip to content

Insurance Fiascos.

March 10, 2009

A little while ago, I wrote a nice, long post about how I apparently owe Medtronic Minimed three thousand dollars – and some change – for an upgrade on my insulin pump so that I could get on the Minimed CGM system.

You should go read it if you haven’t.

Nicole and a few other bloggers left me comments saying that the issue could be that my deductible for Durable Medical Equipment has already been met and that if I don’t make arrangements with United Healthcare, I might NEVER get covered.

After procrastinating for a few days, I finally worked up the nerve (and summoned the strength to deal with an insurance agent) and gave United Healthcare a call.

I explained to Mr. Insurance Agent that I was a type 1 diabetic, had recently ordered an insulin pump and CGM system, and that apparently they had approved the CGM, but not the insulin pump.

“This is kinda weird,” I told him. You know, insurance companies are supposed to like insulin pumps and hate CGMs, not the other way around.

It took a couple of tries before Mr. Insurance Agent to track down the right claim (apparently saying “the insulin pump I ordered last fall” makes one think “January 2009”). But eventually we got to the right amount.

The $3,024.50 amount.

Then he put me on hold while he spoke to a supervisor.

A few minutes later, Mr. Insurance Agent came back. He told me that he had no idea why the claim wasn’t approved and that he was sending this back to Claims with an Urgent Priority. He told me that he looked at my benefits and that my coverage is 100% for in-network (which Minimed is), so there is no reason for me to be billed.

Good!

Minimed doesn’t think I should be charged.

United Healthcare doesn’t think I should be charged.

I don’t think I should be charged.

Glad to see we’re all on the same page!

Mr. Insurance Agent told me that if I wanted, I could call back in 5 days but that the new claim should be posted to my account on myUHC.com. Hopefully this will solve the problem, though I’m not sure why it’s taken Minimed so long to figure this out. Mr. Insurance Agent told me it would only take a few days, yet Minimed has been working on this for a couple of months now. It makes me wonder if my phone call really did any good, or if I’m going to be back on the phone with United Healthcare. As I told Mr. Insurance Agent, “Three thousand dollars is A LOT of money.”

I have better things to spend it on.

11 Comments
  1. March 10, 2009 3:30 PM

    I’m glad you got somewhere with UHC!! When I called UHC debating about Kacey’s pump & supplies, I spent 4 hours being transferred from one person to another…only to get someone tell me I needed to contact Smiths Medical about it. When I called Smiths Medical, all she could tell me was we had a cap of $3500 and anything over that the rest of the year is our responsibility unless we got it waived. Called back to UHC and they said they’d never heard of anyone waiving the cap before. So we’re stuck unless I can find someone who knows what they are talking about at UHC…LOL! I was disappointed with the customer service at UHC and I plan on writing a letter to let them know!😉

  2. March 10, 2009 3:33 PM

    honestly I wouldn’t be surprised if this was deliberate (or routine at least) on UHC’s part, hoping that you would just pay it.

    • March 10, 2009 4:43 PM

      Well, if they wanted to be cheap and get me to foot some of the bill, they shouldn’t have been QUITE SO OBVIOUS with the THREE THOUSAND DOLLAR bill. Actually I probably would have fought it anyway, but still. Three thousand is kind of like throwing someone up against the wall.

  3. March 10, 2009 4:17 PM

    Yay for you! Hopefully it will all be worked out and you will quit getting those pesky bills.

  4. March 10, 2009 4:17 PM

    I wouldn’t be surprised either. I had a certain medical equipment company tell me my Dexcom sensors were covered one day and then when I went to pay my portion of it — them not knowing that my deductible had already been met — said, oh wait no they’re not covered. pftht

  5. Nicole permalink
    March 10, 2009 5:44 PM

    Glad to hear everything worked out. I received my CGMS today. I am going to spend tonight getting myself hooked up!

  6. March 11, 2009 12:39 PM

    Insurance companies are always a huge problem. It takes them a lot less time to get money from you, but it takes them forever to settle a claim. I always think insurance companies are just bunch of scammers.

  7. March 12, 2009 6:37 PM

    One thing you will learn about insurance companies is that they will randomly decline things for no apparent reason. They are in the business of denying claims (nobody ever made money by accepting everything). People (especially diabetics) need to be their own advocate and make sure that you get EVERYTHING you are paying for in your insurance.

Trackbacks

  1. M.I.A. « Lemonade Life

Comments are closed.