Thank you so much. This document is stated more bodly than the previous one. I told them of the new Medicare policy, why it was changed (more cost effective because of fewer infections) that I have had 14, yes 14 UTI's and had been hospitalized once w/ 103 degree fever. I was not getting enough catheters to use a clean one each time. I had an indwelling cath for 1 mo. and saved up the new caths. I went 2 mos. without an infection, started reusing and have had 2 now. I use about 8 per day. If they provided 200 I could pay for the rest, but their policy is - 0 - zero catheters. I asked if they provided any ostomy supplies and they said no. Unfortunately, they no longer need the letter from my Dr. because as they are concerned it is "case closed". I have an attorney to help me and am going to talk to the Okla. Insurance Commission whose job is to be an advocate for the insuree. I'm trying to think of everything I can do. To think, I was upset because they weren't paying for the saline solution! If anyone has any more ideas for "ammunition" for my appeal I would really appreciate it. Also, is there anyone else whose insurance company is not paying for any of their supplies?
11 years 2 months ago - 11 years 2 months ago#23578by Patricia
Kathy......send them the copy of the letter from Medicare.......everything the doctor has to say is in there and they have to follow Medicare's policies.....
I lost my small business insurance with Aetna when my husband died. Since I was already diagnosed with BC at that time, the only insurance I could get was with the Oklahoma High Risk Pool.
I am awaiting a hard copy of the policy, but they state that there is a clause that says that they do not cover disposable medical items including disposable durable medical equipment which includes catheters, saline solution, sterile lubricant, and syringes. Basically everything I need to live with an Indiana pouch. I feel like they feel that they can get away with that because we have nowhere else to go to get medical insurance.
Previously they told me that they would cover catheters and told the supplier 180 Medical the same. After 6 mos. they did not pay the supplier who thankfully wrote the debt off rather than charging me.
I am going to file an appeal. I think it might help my cause if you all would be willing to post a reply with your insurance co. name and what disposable items they provide.
P.S. Since I started having to reuse catheters, I have had two UTI's, one w/ a 102.6 temp.