Old girl T1D trying pump soon!


(Helen) #1

Ok, so I’m going to be a new pumper after 40+ years of syringes and pens!!
When I receive my pump from the distributor they have explained my up front cost and monthly expenses, they say they will bill me directly? I think I have full coverage from my medical insurance for supplies. Do I just purchase the pump only from them? And go t hru insurance for supplies? Or thru medtronics? Confused.
Thanks for any help!


(joe) #2

@Kiwigirl It depends on your plan. Most plans separate durable medical equipment, drugs, and supplies. I have a deductible but my insurance covers most of the pump cost. I go through the pump Co. for pricing and send them my portion after the insurance EOB (explanation of benefit). I go through my pharmacy for supplies and insulin because it’s cheaper for me.

It is important to know what your deductible is and when your insurance will allow you to get a new pump because they are only under warranty for 2 to 3 years.

Good luck pumping has been great for me… after a rocky start of about 4 + months of getting basal rates right.

The book “Pumping Insulin” was very helpful.


(Helen) #3

Thanks Joe, yes pump is covered 80 % with no deductible and my supplies may be fully covered. So will explain this to the distributor and purchase pump only.
Yes I started reading the book, and will also have a few rocky months I am sure!! Thanks :slight_smile:


(Dennis J. Dacey, PwD) #4

Hi Helen @Kiwigirl,

If you are anything like me I’m sure that you will “enjoy” the freedom and tissue saving feature of a pump - not having 5 to 10 needle sticks every day. I too put up with needles for 45 years before converting, even though I had been offered the “backpack” pump many years ago - the 13 years now using a pump are terrific in comparison.

If you are on Medicare [even with enhanced additional insurance], you may have additional insurance issues - my latest pump I got under Medicare guidelines. I did pay 20% of the Medicare discounted price, not list price, and all my pump supplies including eight BG Check strips per day are covered with ZERO co=pay. One drawback, although the manufacturer’s warranty on my Metronid pump is four years, Medicare requires a five year wait and then may NOT permit the latest technology. I ran into this five years ago when the warranty on my old pump ran out and I had to wait an additional year.


(Helen) #5

Thanks Dennis, I’m a few years away from retirement but am looking forward to it immensely! Sounds like the out of pocket monthly expenses are zero for you, that’s great, may not be the same, by the time I get there!!
I have maybe 20 % out of pocket expenses and looks like I have to go thru the distributor, not my insurance co. My calls have not been returned, back on the phone tomorrow. Thanks for all ur info, you are a wealth of information, so appreciate it! Will post again with further issues I’m sure to have!
Thanks :slight_smile:


(Dennis J. Dacey, PwD) #6

You are welcome Helen.
I waited to the first day of my 70th year before retiring thinking that I needed the Company subsidized health insurance plan. Turns out that I was mistaken - my co-pays under Medicare are less and the combined monthly payment both my wife and I make for our Medicare Advantage are less than my monthly payment while working.
Medicare has been good for me - under the work plan I was paying about $70 a quarter for BG Check strips and about $300 a quarter for pump supplies.


(Helen) #7

Hah!! That’s it I’m retiring …not quite! Looks like my monthly pump supplies will be $100.00 and I’m sure in the beginning I’ll use more supplies than that!

Luckily there is no copay for strips.

Medtronic 670G has been ordered…no going back now :wink:

I’m sure to be posting tons of ?

Thanks :slight_smile:

Helen