[Diabetes-Talk] Pump upgrade - to be or not to be ... ...

Sat Feb 16 20:40:49 UTC 2019

Bridget,

Those of us who were given the 530 G as an exchange for the Animas pump had different insurance requirements. I found that out when I had to order my supplies for the first time after my original supply order was running out. Because it was the first time Medicare would be paying for the supplies, I had to go through the whole Medicare packet and review. The original supplies were exchanged for the infusion sets that I had left from the animus pump, and I believe my 530 G was just exchanged for the animus pump. I did not have to pay anything when I did the initial exchange.

      Jamie

Sent from my iPhone

> On Feb 16, 2019, at 8:29 AM, Bridgit Kuenning-Pollpeter via Diabetes-Talk <diabetes-talk at nfbnet.org> wrote:
> 
> Eileen,
> 
> I upgraded in October from my Animas to the Medtronic 530G even though my upgrade with Medicare wasn't up until December. I'm also with Medicare. My doctor sent a letter to Medtronic and Medicare, explaining the situation, and Medicare gave approval for the upgrade in October. I only have to pay $300 for the upgrade.
> 
> I'm well aware of the ridiculous nature of pump upgrades with Medicare. I don't know why this is; it's always been like this as long as I've been on a pump.
> 
> I'm not saying it's right since us blind diabetics have no other options, but Medtronic did make it clear that after October 26, it would no longer provide a warranty on the 530G. It seems it has changed this a bit if your carrier will support it. Nonetheless, we were given a deadline last October. I know a couple of other blind pump users with Medicare who also were able to upgrade and are not paying that much.
> 
> Sorry you're dealing with this.
> 
> Bridgit
> 
> -----Original Message-----
> From: Diabetes-Talk <diabetes-talk-bounces at nfbnet.org> On Behalf Of Eileen Scrivani via Diabetes-Talk
> Sent: Saturday, February 16, 2019 8:16 AM
> To: Diabetes Talk for the Blind <diabetes-talk at nfbnet.org>
> Cc: Eileen Scrivani <etscrivani at verizon.net>
> Subject: Re: [Diabetes-Talk] Pump upgrade - to be or not to be ... ...
> 
> Bridgit,
> 
> Last October right before the pumps were being discontinued, I was ready to spend close to $1000 to upgrade to the 530G last October through some kind of program Medtronics calls Pathway to something or other. Sounds like another great thing, right? Wrong -- 
> 
> It might have been great except for these little points:
> 1.  I would have been spending close to $1000 out-of-pocket for a new pump that's warrantee would have ended at the exact same time as my current pump. Yes, no 5 year warrantee as under Medicare, nor a 4 year warrantee as under any other private insurance plan would get a person, only the remaining 3 months as what was left under my current pump at that time.
> 2. At the end of the day, Medicare with its genius policies would not allow Medtronics to sell me a pump outside of insurance! So I had been screwed no matter what. 
> 
> Then through the Medtronic’s rep that deals with my doctor’s office and who went to bat for me by going high up in the company telling them it just wasn’t right what was being done to me, they finally agreed that come this time when my pump was finally out of the warrantee period they would make sure I would get a 530G that would be purchased under Medicare and therefore I’d get the 5 year warrantee policy with it.
> 
> Eileen
> 
> From: Bridgit Kuenning-Pollpeter via Diabetes-Talk 
> Sent: Saturday, February 16, 2019 8:05 AM
> To: 'Diabetes Talk for the Blind' 
> Cc: Bridgit Kuenning-Pollpeter 
> Subject: Re: [Diabetes-Talk] Pump upgrade - to be or not to be ... ...
> 
> Eileen,
> 
> Can I ask why you didn't upgrade to the 530G in October when Medtronic made it clear the deadline was?
> 
> Bridgit
> 
> -----Original Message-----
> From: Diabetes-Talk <diabetes-talk-bounces at nfbnet.org> On Behalf Of Eileen Scrivani via Diabetes-Talk
> Sent: Friday, February 15, 2019 11:54 PM
> To: Diabetes Talk for the Blind <diabetes-talk at nfbnet.org>
> Cc: Eileen Scrivani <etscrivani at verizon.net>
> Subject: Re: [Diabetes-Talk] Pump upgrade - to be or not to be ... ...
> 
> Veronica,
> 
> Last fall when the discontinuance was going on and I could not get them to let me upgrade 3 months early I did contact Josh Gotheimer a democrat congressman for my district. What a turn off it turned out to be. The staff person I spoke to said she was going to mail me a form to allow her to open a case for me. The US mail was the slowest way possible to send me something that was time imperative. When I did get the mailing from his office it was not a release form, but rather it was a standard form letter that stated how happy they were to have my support! What dopes. No wonder our healthcare is in the state its in.
> 
> As for now, I don’t have much choice other than to wait for next week to hear back from Medtronics to see what if anything they as the company might be able to do for me.
> 
> Eileen 
> 
> From: Veronica Elsea via Diabetes-Talk
> Sent: Friday, February 15, 2019 8:05 PM
> To: 'Diabetes Talk for the Blind' 
> Cc: Veronica Elsea
> Subject: Re: [Diabetes-Talk] Pump upgrade - to be or not to be ... ...
> 
> OMG! This is crazy! Does anyone actually get into the business any more because they actually want to help people? Or improve their lives? Do they have any thought for how much extra they're going to pay because of the negative health effects caused by all this extra stress? 
> This is one of the things that concerned me last year about getting a discontinued pump. That, and if it breaks, would they be able to overnight one to me? Eileen, if you can find it within yourself, this is a time to call your Congressional representatives. We need to start bombarding them with each instance where the stupid rules and buddy buddy agreements prevent us from getting good health care for reasons which we cannot possibly control. Someone should be able to help you apply for a waver here. And you could convince me that they deliberately drop these things on us on Friday so we have to sit with them all week end, hoping we'll give up. 
> So, feel free to get it out of your system here, so we can help back you up as you fight for what you need. I don't understand why Medicare can't work like every other commercial insurance agency. They could save a bunch of money if they'd just ditch the huge staff that does nothing else but look for that tiny tiny fraction of so-called fraud they're chasing. Bet they spend more trying to find it than they save by stopping anything. I still can't figure out how they are allowing me 3.92 injections per month of my Enbrel. What are they going to do, short sheet one of the pens? <growl.> I am so sorry you're going through this. So let me take this moment to loudly proclaim, Eileen deserves an up-to-date accessible insulin pump which is covered under warranty. Now!
> There. Maybe I can help you to get through this just a bit. Holler at me any ol' time.
> Veronica
> 
> 
> "Guide Dogs, First Hand", Veronica Elsea's classic album is now available on iTunes, along with other music from her and from the Guide Dog Glee Club. 
> To learn more, visit:
> http://www.laurelcreekmusic.com
>                Veronica Elsea, Owner
> Laurel Creek Music Designs
> Santa Cruz, California
> Phone: 831-429-6407
> 
> 
> 
> -----Original Message-----
> From: Diabetes-Talk [mailto:diabetes-talk-bounces at nfbnet.org] On Behalf Of Eileen Scrivani via Diabetes-Talk
> Sent: Friday, February 15, 2019 2:35 PM
> To: NFB Diabetes Talk
> Cc: Eileen Scrivani
> Subject: [Diabetes-Talk] Pump upgrade - to be or not to be ... ...
> 
> Hi All,
> 
> I need to blow off steam over the hell I’ve gone through trying to get my insulin pump upgraded. As you may or may not recall I have been using the Medtronics Paradigm pump which just came out of its 5 year warrantee.
> 
> Through persuasion from higher levels, Medtronics was agreeable to letting me upgrade to one of the 530G pumps that got discontinued last October so I would still have a working pump that would be under warrantee coverage over the next 5 years. I started the process with Medtronics about 2 or 3 weeks ago. Medtronics in turn reached out to the  supplier I’ve been dealing with all these years to see if they still had a 530G in stock and they did. Great, right? You would think so but here’s where the process once again goes crazy. 
> 
> The supply company contacted me 2 days ago about paperwork I had to sign off on for Medicare & to let me know they were sending more paperwork for my doc to sign off on. I signed what I had to as did my doctor. I just got a call from the supply company telling me they cannot sell the pump to me because under Medicare they will only agree to pay for an insulin pump up to a bit over $4,000. Even if I could pay the amount beyond the Medicare limit they won’t let me! They cannot sell the pump outright to me and they won’t let me cover the difference that Medicare will not pay for so I’m stuck again with not being able to upgrade my pump that is now over 5 years old. This is so phenomenally upsetting & the absurd rules of coverage. the supply company’s rep  told me that unless I wanted the 630G she could not let me have an insulin pump! How crazy is this system that a now discontinued pump is more expensive than the newest version of the Medtronics insulin pump. I’d love a 630G if I had the eyes in my head that worked so I could use the dam thing!
> 
> I have a call into the Medtronics rep to see if they know of other distributors that might work something out with me or sell the 530G for a less expensive price. Now I get to wait over a long holiday weekend thinking I’ll not be able to upgrade. God help me if I have to go back onto injections.
> 
> Thanks for listening to my sob story.
> 
> Eileen
> 
> 
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