1. Home
  2. ⏣ General Metalworking
  3. WAY OT: won insurance company appeal

WAY OT: won insurance company appeal

My better half has diabetes, type 1. She's been taking insulin for years. For some reason, control of her blood sugar has become extremely difficult. Poorly controlled diabetes, over time, causes things like kidney failure, blindness, foot amputation, etc.

Medtronic Inc. has just come out with a new constant blood sugar monitor. It takes a sample once every five minutes 24 hours a day. The data is fed to the special new insulin pump. This new technology looks to be the greatest improvement in diabetes management in years.

Trouble is, insurance wouldn't pay for it. We got one anyway. The costs are extreme, but nothing compared to the costs of treating the known complications.

We started the appeals process for coverage. Last night, we got word that we won the appeal!!! To our knowledge, we are the first in the USA to get insurance coverage for this new device.

If you have a loved one with type 1 diabetes, let them know about this. It will simply extend and improve the quality of their life.

Reply to
Karl Townsend
Loading thread data ...

Reply to
kfvorwerk

Congratulations. I never could figure that one out, insurance companies will pay to get you well, but they won't pay to keep you from getting sick.

I guess they realize that if eveyone practiced preventative care, they'd lose their 20 percent of all the treatment costs!

Jim

Reply to
jim rozen

Karl Townsend wrote: , we are the first in the USA to get

Good news Karl. Thanks for sharing. Bill

Reply to
lathenut

Congrats!! I know how hard it is to fight this sort of thing.

Do you have a model number or something? Or maybe a URL for it on the Medtronic website?

I guess there's a blood shunt implanted that it uses to draw blood sugar measurements?

A friend of mine is diabetic and I'd like to pass the details along.

-gc

Reply to
Gene Cash

formatting link

Its similar to, but larger than the one used for an insulin pump. They officially last for three days. Julie's nurse said many had tried for two three day periods with good results. This is working for her. Saves a bit because they are $40 a pop. If you don't already have a pump, they are $5000. You'll have to upgrade if you have a pump, cost depends on what you return. The reading unit is about $1000 and lasts six months. You still have to check glucose with the blood stick but not as often. Of course, NOW ITS ALL COVERRED BY INSURANCE.

karl

Reply to
Karl Townsend

They tend to pay whatever is less, getting you well, versus keeping you from getting sick-before-they-can-kick-you-off-their-policy.

Fancy monitors priced in kilobucks are not necessarily the latter.

Don't forget that "kick you off" includes "after you're dead."

Once your expected payout approaches or exceeds your premiums, you're not welcome. Diabetics in group coverage almost always face this. Insurers do not willingly cover near-certain risks.

Reply to
Richard J Kinch

Or, as one company spokesman said "we don't insure burning houses."

The odd thing is, this will eventually spell the death-knell for private insurance as we know it today.

Private insurance is about spreading statistically uncertain risk out in a pool of insured customers. If the customers and the company both know exactly what the risks are (no statistical uncertainty) then the company will not write a policy for somebody with 100% risk. And those who have 0% risk will not want to buy one anyway.

This is already beginning to happen in the industry.

Jim

Reply to
jim rozen

PolyTech Forum website is not affiliated with any of the manufacturers or service providers discussed here. All logos and trade names are the property of their respective owners.