Sunday, January 3, 2010

Out of pocket costs?

Ok, so as happy as I am about the fact that I'm getting a pump . . . I didn't realize it would be so expensive! I mean, I kinda figured that was why it was so important to get the insurance company to actually approve me. If I could afford all these out-of-pocket costs, I coulda just paid for it all myself!

So I'm kind of wondering how normal my coverage is? Please weigh in! My insurance is covering a straight 80% of all pump costs. This means that I have to pay $1150 for my pump, which includes $120 for my first set of supplies. The Animas rep says that the supplies technically come as a 90-day supply but can last longer (up to 4 months) depending on user habits.

I was expecting the fees for the supplies, but I wasn't expecting such a high start-up cost for the pump itself. Is this normal? I don't know why but I thought we were expected to pay our copay for the supplies but that the insurance company pretty much covered the pump. Am I dreaming?



  1. I've been just as confused with my insurance. Orginally I was told my pump and supplies would be paid for after I fulfilled my "out of pocket expenses." Now - it seems I'll be paying 20% of the pump but the supplies will be DME and there's no copayment. I still haven't received a bill and the pump arrived in October. Until I see the bill(s), I'm making no assumptions.

  2. I think I had to pay somewhere between $800 - $900 co-pay for my pump when I started in April 2008. I was not expecting to have to fork over that much either. I really don't understand how we can have insurance and they can approve a pump, but we still have to pay around $1000 for it. Just another Not Fun thing about dealing with diabetes, huh?

  3. That's a pretty normal coverage. Mine is also 80% and I'm really dreading it. When I first got my pump I lived with my parents and didn't have to pay a penny for it. Now my warranty is expired and I'm just scared of the day my pump quits working. They are a bit hard to swallow for the start up costs - but totally worth it. I love my pump and will be upset if I have to go back to shots for awhile if my pump breaks anytime soon!

  4. When I was deciding on pumps, I asked the Animas rep how negotiable the price was--and he dropped the price by $300. Then I said I wanted to try different infusion sets before deciding on one type. He sent me two boxes of various samples.
    Ask for everything and see what happens!