Pump and insurance

Does anyone know what pumps are ‘preferred’ by insurance companies? I have Aetna and am afraid I’m going to be 100% responsible for paying for the pump. That brings me to my next question…what does most pumps cost?

Thanks!!!

It really depends on your insurance. But I believe Medtronic minimed has been around the longest or close to so you’re pretty safe with that choice. I have Kaiser and they cover Medtronic, animas, and tandem. I currently have a tandem and have also had a Medtronic pump. Straight off (before insurance) pumps are around $5,000-6,000) Before the health care reform and when I had really shitty health insurance because I was paying out of pocket, my copay was $2000 but Medtronic gave a really good payment plan that I ended up paying it off over 2 years. I think if you can swing it it’s definately worth it to get a pump.

It may be a good move for you to move to the pump - I wish they were available 50 years before I switched.

If the endocrinologist who assists you in management of your T1D [you should be your primary care-giver, my opinion] prescribes a pump as appropriate for you, your insurance company must consider providing the pump and the pump supplies. It is likely that your doctor when prescribing will say which pump you should use and it is likely that she will arrange contact for you with the pump representative. Then, that manufacturer’s representative [yeah, sales person] will take charge of pushing the Aetna process; Medtronic did this for me with my first pump and then subsequently at expiration of warrantee for replacement upgrades.

Price will vary depending upon the contract between Aetna and the pump manufacturer and you would most likely be responsible for the Durable Medical Equipment co-payment. A year ago I got a new Medtronic #523 with a “List Price” I believe of $7,430 and my cash out-of-pocket was about $500.

Good luck to you on making the change - stay in contact.

Aetna’s a normal provider, so I would think at least Minimed and Animas should have no trouble being covered. However, you may need justification from your doctor and evidence that you can track your BG’s religiously before they’ll consider covering it. But Aetna’s customer service team should be able to tell you.