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daniel velazco |
daniel velazco replied October 11, 2009 1:44 AM
I have been out of the military for over
GiGiB replied October 15, 2009 2:15 AM Hi dan
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Harlen |
Harlen replied October 11, 2009 1:59 AM
I wish you the best luck ever
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Harlen |
Harlen replied October 14, 2009 1:04 AM
I know why they are doing it
2catty replied October 14, 2009 10:38 PM Harlen you are right. They are the cheapest pumps to get and start-up but they become the most expensive to buy the supplies for. That is why insurance companies don't like them. Plus alot of them say they have to many pod failures. I have the animas ping and love it. But I don't blame you for fighting to keep what you like. It should be your call.
GiGiB replied October 15, 2009 2:10 AM Hello
GiGiB replied October 15, 2009 2:13 AM Hi Harlan
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Sarguillo |
Sarguillo replied October 14, 2009 9:57 PM
Does Triwest have a parent corporation? One that oversees the others? If so, try appealing to them.
GiGiB replied October 15, 2009 2:12 AM Hi. Actually it is Tricare and then it get broken down in to regions as the military is all over our country: west is Triwest, North is Tricare north etc etc. I am almost ready to submit my appeal and I have a Congress member on my side. Too many people tell me I can do this but I can!! thanks for your response. |
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Judimar |
Judimar replied October 15, 2009 6:13 AM
I don't blame you for fighting it. Work your way up the chain of command. Insurance companies are NOT doctors...GAH this just makes me so angry...
GiGiB replied October 15, 2009 3:40 PM Hi Judy,
Crashnot replied October 15, 2009 4:20 PM You go girl! We're with you! And this is a marvelous precendent to get more insurance companies to shape up!
GiGiB replied October 15, 2009 5:39 PM Thank you! I will keep you posted on what is going on. I am also hanging on to all my contacts in case someone needs help. Thank you so much for the positive response. Our society is way too compliant about issues! Let's keep in touch!
Judimar replied October 15, 2009 10:13 PM NP GiGi! I was an army brat and I saw my mom struggle to get her diabetic syringes and alcohol wipes back in the 80's. She was told since my dad was retired they wouldn't help her at all. She fought her way through the chain of command and the insurance company and got them to comply. I know it will be tough and frustration but you are definitely worth it!
GiGiB replied October 16, 2009 4:51 AM Hi Judi!
Crashnot replied October 16, 2009 4:52 PM Last edited about 1 month ago Lord knows, few military personell get paid what they're worth, you better get your money's worth for helping the troops be all they can be! |
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GiGiB |
GiGiB replied October 23, 2009 4:52 PM
Hello! I wanted to give an update on my progress. It looks like the policy is being rewritten at TriWest. I am now getting word that TriWest will cover OmniPod and its supplies! It just goes to show....never settle for second best AND, don't listen to the people who tell you that it cant be done or why bother?
Crashnot replied October 23, 2009 7:35 PM Can we nominate you for the determined and stubborn award? :-)
GiGiB replied October 23, 2009 7:46 PM I will gladly take that :0)
Judimar replied October 24, 2009 9:54 AM GiGiB,
GiGiB replied October 24, 2009 3:13 PM Thank you Judi!! I have been trying to get the word out to the small group of people that contacted me for help. I am helping another lady who has Blue Cross. Thank you for being so supportive!
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My husband is active military, and we are under Military health care – Tricare. In 2008 we were transferred to California covered by Tricare West, which is when my problems began.
I am a type 1 diabetic and have been for 37 years. Prior to getting the pump in 2007 - approved by Tricare North - I had diabetic retinopathy which left me partially blind in one eye. I have kidney damage. I take medication for high blood pressure. The Insulet Omni pod pump has allowed me to maintain excellent blood sugar control and to lower my A1C from 8.9 to 4.2.
Since transferring to Tricare West, Paul S. Molchan, the Medical Director, has once before denied me my pump supplies, stating that the supplies were not necessary for my diabetes. After one month of stressful fighting to get my pump supplies, I finally succeeded.
Just one week ago, prior to my next 3-month supply order, Mr. Molchan, again denied my pump supplies. I learned that he decided in June 2009 that the Insulet Omni pod pump was a “luxury item” and could be used ONLY for special case gestational diabetics (pregnancy). This decision is unique to Tricare West since according to the Insulet company, Tricare North and Tricare South continue to approve the Omni pod pump and its supplies.
Despite a telephone appeal to Mr. Molchan on Friday October 9 from my primary care doctor, the request for re-instating my pump supplies was not approved citing a regulation that standard products preferred. However, diabetes is a chronic disease that can cause death. This denial for pump supplies has meant that I now must begin the fight anew.
Since I already have the Insulet pump and only need the supplies, the purchase of another pump and training classes will cost the US government at least $6,000, a waste of taxpayer’s money. Furthermore, the Insulet pump has successfully allowed me to be in the best of health ever, saving the US government money. Any adjustment to something new will affect my health and blood sugar levels .
To further complicate this situation, Tricare West has erroneously listed the supply clerk at Insulet Company as my physician. So, I am now fighting to have this error corrected, but no one will take action or even return my phone calls at the Tricare West Enrollment Division.
As a result of this, I am seeking an investigation into Tricare West and Paul S. Molchan, the Medical Director, This decision is not only irrational and irresponsible but it affects ONLY those diabetics using the Insulet insulin pump covered by Tricare West. No diabetic, especially military, should have to undergo this type of stress just to stay alive.