As far as I know, the reasons Uncle Joe is in the hospital right now are not diabetes related, although they are still running various tests to determine what is going on. But naturally, diabetes usually comes up in our conversations. This morning he asked about my pump - how I like it and how it works. I know he has a hard time with diabetes. A few months ago he had a really bad low and was taken to the hospital by ambulance. He was switched from oral meds to insulin years ago. He seemed genuinely fascinated as I explained my pump and he asked to see how it connected to me. As I showed him the infusion site on my leg and explained how I change it every three days, he asked “Could I get an insulin pump?”I told him I thought he could if his doctor prescribed one for him. I do think it might help him. I know he struggles with both high and low blood sugars, and his A1C is never where he and his doctor would like it to be. But alarm bells went off in my head when I thought about insurance. He has great insurance, but I honestly have no idea if it is difficult for a Type 2 to get approval for an insulin pump. So I’m reaching out for advice and information. Who better to ask than the DOC? Does anyone have any information I can pass along to Uncle Joe?
I have no information. However, since coverage of d-tech for T1s seems to vary not only by insurance company but by the phases of the moon and the state of Singapore's stock market, I'd think it would be worth at least starting the process.
ReplyDeleteI know of several Type 2's who have pumps. The issue, however, is whether he would come in under the C-peptide cutoff for Medicare to cover it. If he comes in over the line (110% of lowest normal measurement) then Medicare won't cover it, and then it depends on if he has secondary insurance that will. This rule was essentially written to keep Type 2's off the pump, because there are so many of them, and it would be expensive to provide pumps to all insulin-using Type 2's who could benefit from it. With Medicare, the issue is money, not quality of care! :-(
ReplyDeleteAs a type 2, yes I have one. Most people I know that are on a pump are type 2.
ReplyDeleteI am a Type 2 and have been approved for a pump with BCBS. I think, though, that the C-peptide limit applies for some insurances other than Medicare too, but it would just have to be something he would check into.
ReplyDeleteMy mother is type 2, on insulin. Thank you for bringing this to light...and thank you to your awesome readers for some amazing insight!! Hope your unlce is home and feeling better soon!
ReplyDeleteHope you're uncle feels better soon, Karen. I also know nothing in regard to Type 2s getting pumps, but just anecdotally have heard the same things about C-pep test results as far as insurance. Might be something for him to discuss with his doc as far as medical necessity and to check with insurance from there.
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