Will it ever happen?....

I suppose the big question on people's minds lately is:

When will J.J. get on the pump?

I'd love to know that myself. One thing we've learned in the past 9 months is that the medical industry likes to take their time. To get things moved through faster it takes time, energy, and resources. Of which I have none.

Medtronic called me this morning wanting to send out J.J.'s pump supplies. I had requested they contact me with a final authorization before they shipped. So they call today to tell me the basics, but then tell me that Medtronic is not an "in-network" provider. Meaning it will cost a lot more to buy from them.

We determined that our insurance has a distributor that we need to order from to get better benefits. I had to cancel the order (which took 2 weeks to process) from Medtronic, then call this other company. Thirty minutes later, J.J. is in the new system and set to receive his supplies by THIS FRIDAY!!!

WHAT? FRIDAY? YEAH--RIGHT!!!

I chuckled when I heard that. The sweet customer service rep. assured me that the their company moves things through quickly and worst case scenario would be next Tuesday.

Should I hold my breath people? Will he have his supplies by next week this time??? Could J.J. be on the pump within the next two weeks?

Donated Medtronic Pump News......

Earlier this week the CDE coordinator at our clinic called to tell us the "process" Medtronic uses to get their "paws in the cookie jar", so to speak!!! We were told that to use the donated pump we needed to send it in to Medtronic, and have the original owner contact Medtronic to have ownership transfered to us. We then get a "new" pump with the same platform......not a newer model, just a different pump, same model, that they deem usable. All warranties transfer, but if there is no warranty, well, then we are stuck....stuck paying Medtronic $495!! Yes, it's true, for this "service" Medtronic requires a fee of $495!!! OUCH!! So much for my dreams of getting donated pumps to people that need them!!

Needless to say I was a little bummed about this the day she called. We really want to just use this pump for a short time, to get us acclimated to pumping......see if it's "our cup of tea"....and give us time to save. That $500 would be a good start to saving up for the next pump.

Hubby believes we must be paying Medtronic for their "help" line, which I've read can be an invaluable resource especially if you don't have a great endo clinic.

So.....here is the status thus far. I wrote the clinic back this morning and wondered if we could move forward with the pump process with the donated pump, but without sending it into Medtronic. If the pump is unusable we'll be able to tell because of the close monitoring that goes on in the beginning. She replied back saying she totally understands what we are saying, but that the clinic has never, as far as she knows, encountered such a situation. She is going to run this by a bunch of people and get back to us in a couple of days.

I called my contact today about the pump. Unfortunately her grandmother died...:-(, so I wasn't able to speak to her, and I certainly don't want to bother her at this time. So I have no idea if the pump is still warrantied.

We called our insurance and they "say" they typically do approve pumps, but a full medical review would have to still be involved. With J.J.'s A1C being so high I can't imagine they'd deny the doctor's request....but then again.....yes, I can. Anyhoo....if they do approve the pump it appears the cost would be $3,500 instead of $6,000. Oh, to be Katie, and get the pump for $25!! What a dream!! Can you see the jealousy meter go off the charts!!???

So, I guess we are in a holding pattern. So many decisions to be made. I don't know....I could swallow a couple hundred in "fees" but $500!! OUCH AGAIN!! So now we may be facing another decision....to cough up the $500 for an unknown situation....the pump they send may not work either, but if it doesn't and there is no warranty well then we are seriously stuck...and out $500. OR We may just end up waiting until we have the money to cover the cost of a new pump. I'm kind of really hoping they just let us get on with the training so we can get to using the pump. I really hate all this decision making....

As a side note.....I called to schedule an appointment with our "hospital endo"....she was booked for the next 3 1/2 months!! All the way into JULY!! You know what that tells me....she's good!!! So I'm stickin' with her. The extra drive will be worth it....I'll just have to make use of all the splendid educational opportunities that await us in St. Paul!!!

Health Insruance STINKS....A little venting...

Warning:  This post is a venting post....I'm sad, angry, and frustrated right now....I'll post it for now, but may delete it when I gain my composure!!

 

We just received a notice in the mail telling us the insurance is now approving 200 test strips and 200 syringes.  This is still 100 less than my doctor is prescribing……and at least 50 less than what we actually use in a month.  I am frustrated with our insurance.  How do they decide what is "medically necessary" for my son?  Are they just sitting in some office thinking  "Well, they're asking for 300, we only want to pay for 100, how about we offer them 200…sounds like a good number."  How can they say only 200 is what is "medically necessary"?  LIVE WITH ME FOR A MONTH!!!  How am I supposed to determine how much of the "medically necessary" insulin I'm to administer to my son without testing his blood?  I just looked back at our log for the past 15 days…128 tests!!  ALL MEDICALLY NECESSARY!!!  Double that number we are looking at around 250-260 a month.  I am just trying to understand….we've paid our premium for how many years?  Being self-employed is tough enough, and we even contemplated not having health insurance at times to make ends meet, but always thought…."NO, we just don't know what could happen…it's good to have."  But what good is health insurance if it doesn't pay for what is needed to keep you or your family healthy?  TO KEEP THEM ALIVE!???

 

Well this may seem like a little thing…so what?  "At least they'll pay for 200"…and yes, at least they upped it a little.  But what about the insulin pump….we have to go through the same process.  It has to be deemed MEDICALLY NECESSARY!!!  I just can't see them approving the pump at this point if they aren't willing to see the need to check blood more often in a small child!!!  How do I scream on paper?

 

Wow!!!  After crying my eyes out for a bit, and typing this post….I feel some better.  I am assured through scripture that "My God will supply all [my] needs according to His riches in glory in Christ Jesus"..(Phil 4:19)  I'm may not see HOW He'll supply, but I'm assured that we will be supplied with exactly what we need.  As a side praise….yesterday we received a card in the mail with $50 cash in it.  No name, no return address, just a note card with the money inserted in it.  We put it directly into J.J.'s savings account we set up for his medical needs.  That will cover the extra 50 tests we'll need for this month!!  Thank-you God…and bless the tender heart that sent it!!

 

Now….I have to compose myself, try my best to put this all aside and get ready for a night out with my husband….our first "date" since the big D-day!!  Any advice on covering up puffy, swollen, red eyes??     

Just added frustrations.....

I've spent the past couple of days dealing with our insurance company, the hospital, and bank!! UGH!!! It doesn't make my mood cheery that's for sure!! We've never had anything major happen medically in our family...besides babies, miscarriages, broken toes, ear infections, etc. So to have to deal with not only diabetes, but the insurance and the medical entities wanting their money is very draining.

We are still fighting to have the insurance pay for the test strips. Our Endo prescribed 300/mo. but the insurance only wants to pay for 100. They cost us $1/strip. And we are finding that we do go through close to the prescribed amount each month. We've had to contact both our insurance and our clinic to follow up. Just amounts to a lot of time on the phone. I found out yesterday that the insurance does have the information they need now, but it's in review!! We are so praying that they approve the test strips.

We finally got the hospital bill yesterday as well. I called this morning to set up payments, and was given a ridiculously high amount.....for us right now, anyway....the lady was snippy....not a great way to begin my Saturday!!