self testing and insurance

[Dennis S]

We had some good news that might be helpful to others. I had my aorta valve replaced Aug. 4th. The surgeon gave me a "range" of 1.8 to 2.5. I was fortunate to hit it almost immediately, and my primary Dr. likes it at 2.5, so I am staying around there for now.

We live about 80 miles from the nearest Dr. and need to self test. Our Dr. prescribed a home test machine, but our insurance company told my wife & myself in separate conversations that they would not cover the machine or supplies. We decided to bite the bullet and pay for our own machine. Based on some things I read on the forum & elsewhere, I decided on the "Inratio" monitor. to place our order we went through a company called "Raytel". They heard our story, and asked if they could contact our insurance company. Next thing I knew they called back and our insurance agreed pay for the monitor and all supplies. I did my first self test today!

I guess the moral to the story is don't ever give up when dealing with insurance companies. And, I think there is some movement towards covering self-testing equipment. I hope this might help others who would like to self-test but get an initial denial from their health insurance companies.

 

[Cris N]

I'm happy you got the coverage, especially with the distance you'd have to travel. My ins., which has really been quite wonderful, says I'd have to pay a $500 deductible and then 20% of the cost. Don't know about the supplies though.

I will have to wait a while, can't come up with the cash right now. So, instead I will continue to go in for weekly testing which they happily pay for - go figure.

Cris

 

[Ross]

That's great! I wish more people wouldn't give up so easily. Darn insurance companies want their premiums, but don't want to spend any money on you.
I think you'll be real pleased now. It gives you so much more freedom and soon, with your Doctors blessings, you may be self dosing also. Anything beats constant veinous sticks!

 

[catwoman]

I'm happy you got the coverage, especially with the distance you'd have to travel. My ins., which has really been quite wonderful, says I'd have to pay a $500 deductible and then 20% of the cost. Don't know about the supplies though.

Cris:
Is the $500 a yearly deductible for all expenses? My annual deductible (UHC) is $200 for in-network, $500 for out-of-network.
Raytel became in network for all of UHC, as of 8/1/05, according to a UHC patient care coordinator rep.
Do you have a flex plan for your medical expenses through your employer? I have had one for 2+ years. It really helps tax-wise to have one if you have a lot of medical expenses. You can get reimbursed for your deductible amount that insurance didn't cover...

 

[Karlynn]

For anyone wanting to get a home testing unit I would suggest that they start first with the companies that handle them. QAS and Raytel are the ones I know. They are experienced in getting approval from insurance companies, so if anyone can get the approval, they can.

 

[Cris N]

Cris:
Is the $500 a yearly deductible for all expenses? My annual deductible (UHC) is $200 for in-network, $500 for out-of-network.
Raytel became in network for all of UHC, as of 8/1/05, according to a UHC patient care coordinator rep.
Do you have a flex plan for your medical expenses through your employer? I have had one for 2+ years. It really helps tax-wise to have one if you have a lot of medical expenses. You can get reimbursed for your deductible amount that insurance didn't cover...

I believe this is only for the durable - I don't have a deductible for regular medical expenses. I just started at employer this past winter & didn't sign up for flex... and I keep forgetting to do so. Maybe this will give me the swift kick that I need. Fortunately the only expenses I really incur are the small co-pay on meds. I am UHC - will check with my care coordinator about Raytel... when I spoke to her she mentioned (in my area) Walgreens (special services) and Apria. Thanks for the suggestions...

Cris