Insur not covering supplies - I need advice

New Topic Post Reply Printable Version
[ << Previous Thread | Next Thread >> ]

chili123
Regular Member


Date Joined Jan 2007
Total Posts : 300
   Posted 2/22/2008 9:17 AM (GMT -6)   
I just called my insurance company to find out that they do not cover any ostomy. That is stessing me out. Anyone out there have to pay for their own and, if so, where can you buy them that is less expensive? Other than doing just a random search on the internet is all I know to do but I don't know if there are bad places out there to order from. Any help or guidance would be appreciated.

Pancolitis - July 2006
Medications:  Predisone - 5mg ,asacol - 12 tablets per day
Supplements:  multi-vit, calcium, folic acid
My wish:  get off prednsione....been on straight since 8/2006


Irish_Mom
Regular Member


Date Joined Apr 2007
Total Posts : 385
   Posted 2/22/2008 9:32 AM (GMT -6)   
Wow, that's crazy. I've never heard of an insurance company not paying for ostomy supplies. What insurance do you have?

Terri
 
_________________________________________________________________________________
Breast Cancer at 36. Diagnosed in 2000. Bilateral mastectomy with reconstruction.
Sub-Total colectomy in September 2007 for colonic inertia.
Son diagnosed with Crohn's at 17 (now 21). Taking Asacol and 6MP with Prednisone and Rowasa added during flareups.
Husband HLA B27 postive with ankylosing spondylitis and psoriatic arthritis.


chili123
Regular Member


Date Joined Jan 2007
Total Posts : 300
   Posted 2/22/2008 9:36 AM (GMT -6)   
I have United Health Care. I called and they said that my husband's company did not purchase a policy or waiver or something so they are not covered. My husband works for a small company so they probably didn't think anyone would ever need it???? It is making me stressed out for sure.
Pancolitis - July 2006
Medications:  Predisone - 5mg ,asacol - 12 tablets per day
Supplements:  multi-vit, calcium, folic acid
My wish:  get off prednsione....been on straight since 8/2006


tbraz
Regular Member


Date Joined Jul 2007
Total Posts : 280
   Posted 2/22/2008 10:34 AM (GMT -6)   
Are they paying for the surgery? I would think that if they cover the surgery, they would have to cover the supplies as they are medically necessary just like a prescription would be. That's like telling someone with cancer "We can pay for them to take out your tumor, but aren't going to pay for chemo" How ridiculous!! You have to have the supplies after the surgery, there is no choice!

Maybe you can call the ostomy nurse at the hospital where you are having surgery and ask if they've dealt with your insurance company before. They might also know where you can get discounted supplies or ones that have been donated. I am amazed everytime I look at the total of my orders and can't believe how expensive they are, I can't imagine having to pay for them out of my pocket!

I also have a friend that has no insurance and has an ostomy. I told her that she would probably qualify for medicaid since she has a condition that requires medical supplies. You might want to check with your state medicaid and see if you could be covered as well for just your supplies. I work at a hospital and I know some people have health insurance and also have medicaid.

I hope you can get your answers!
Theresa

Originally diagnosed with CD in 1991
Only one serious flare up in 1998 and again in July 2007
Total colectomy August 2007 now saying "Undetermined Colitis"
2nd step J-pouch formation -January 2008
Takedown hopefully by April 2008


Indabag
Regular Member


Date Joined Aug 2007
Total Posts : 254
   Posted 2/22/2008 10:35 AM (GMT -6)   
Hi Chili:

I used to have United too. United Health Care had a deal with Edgepark where those covered by UNC would get a 40% discount on ostomy supplies. Most of the telephone reps at Edgepark are familiar with this arrangement. Although the supplies are still expensive, even with the discount, it did save me a lot of money.

I know that many of us have had success in getting samples and I heard some supplies may even be available on E-Bay. Good luck in your search and let us know how you made out.

Richard
Indabag
 
Ileostomy since August 2005.
As result of surgery (modified whipple) for necrotising pancreatitis. Removal of gallbladder, 2/3 of pancreas, resections of large and small intestines. Massive infection. 8 months in ICU at Westchester County M.C. (I think that's a record). Second surgery for resection due to fistulas in January 2007. Been slowly recovering since then. Possible reconnection candidate.


suebear
Forum Moderator


Date Joined Feb 2006
Total Posts : 5692
   Posted 2/22/2008 10:54 AM (GMT -6)   
This is a sad reality, some insurance companies cover the costs of ostomy supplies in full, others partially, and some not at all.

Sue
dx proctitis in 1987
dx UC in 1991, was stable until 1998

1998 started prednisone, asacol, pentasa, nortriptylene, ativan, 6MP, rowasa enemas and suppositories, hydrocortisone enemas, tried the SCD diet, being a vegetarian, omega 3s, flax, pranic healing, yoga, acupuncture, probiotics

2000 lost all my B-12 stores and became anemic

2001 opted for j-pouch surgery- now living life med-free


praying4healing
Veteran Member


Date Joined Dec 2007
Total Posts : 739
   Posted 2/22/2008 11:12 AM (GMT -6)   
mayb u should check with your hospital where ur ostomy was performed. mayb they can give assistance. I was reading on the convatec website under "medicare and insurance" that ostomies are considered prosthetics, if thats the case, u should b able to find assistance somewhere, i guess u just have to know where to look. there are also other helpful links on the website. I wish i had more answers for you, mayb u can check with a social worker at the hospital?
25 y/o female- crohns disease since 14
Ileostomy pending-very worried
Tried asacol,pentasa,prednisone,remicade,6mp,azasan, no avail
Seatons placed
Worst year ever!

"For God has not given us the spirit of fear....."
Where does mine come from?!
 
Temp Ileostomy performed 1/29/08
Still Adusting
 
Healingwell.com has been my Godsend...Thank you


chili123
Regular Member


Date Joined Jan 2007
Total Posts : 300
   Posted 2/22/2008 11:32 AM (GMT -6)   
Yeah, I will check it out. I posted also on jpouch and there was a lady that said ostogroup and red cross. I did contact a couple of places via email (red cross and some other place out of nevad) to find out the requirements to qualify so I am looking forward to hearing back from them. I also called a supplier and they offer a 40% discount if I have United Health Care - so that certainly would help.
Pancolitis - July 2006
Medications:  Predisone - 5mg ,asacol - 12 tablets per day
Supplements:  multi-vit, calcium, folic acid
My wish:  get off prednsione....been on straight since 8/2006


Shaz032
Forum Moderator


Date Joined Feb 2003
Total Posts : 1246
   Posted 2/22/2008 11:41 AM (GMT -6)   
Try http://www.ostogroup.org/   They're a group in the US esp formed for those who don't have insurance or those whose insurance won't cover supplies - all they ask is for postage. E-bay, believe it or not, is another good place to get cheap supplies.
 
Sadly, I've heard many similar stories from people in the US, whose insurance company won't cover their supplies (United Health Care are notorious and the one company that does come to mind!). Some companies won't cover supplies cos they class ostomy supplies as purely 'cosmetic' - apparently, they think they're the latest fashion accessory!  I tell people to go and sit in their insurance companies offices without a bag on just to show the company exactly how 'cosmetic' our supplies are!


I have had an ileostomy for 32 years now due to UC.
 
Moderator of the Ostomy Forum
_______________________________________________
 
I'm not a complete idiot - some parts of me are missing!

Post Edited (Shaz032) : 2/22/2008 10:44:49 AM (GMT-7)


praying4healing
Veteran Member


Date Joined Dec 2007
Total Posts : 739
   Posted 2/22/2008 2:00 PM (GMT -6)   
i'm totally with you shaz! how stupid!
25 y/o female- crohns disease since 14
Ileostomy pending-very worried
Tried asacol,pentasa,prednisone,remicade,6mp,azasan, no avail
Seatons placed
Worst year ever!

"For God has not given us the spirit of fear....."
Where does mine come from?!
 
Temp Ileostomy performed 1/29/08
Still Adusting
 
Healingwell.com has been my Godsend...Thank you


chili123
Regular Member


Date Joined Jan 2007
Total Posts : 300
   Posted 2/22/2008 4:41 PM (GMT -6)   
I have had very good luck today getting some help. There is a local place here that has committed to provide me with free supplies and then another place out of state. I am not sure what exactly I need nor do I know to what degree that provide so I thought having two resources may turn out to be beneficial. The local choice is a better choice because they do not charge shipping or anything - sounds like zero cost. The other choice charges 10% retail plus shipping. Anyhow, I think that it has been a blessing. It has taken some stress off. I am nervous about monday.....very nervous. When I wake up tomorrow, it will be less than 48 hours. I think that I am so nervous that I feel kinda depressed.
Pancolitis - July 2006
Medications:  Predisone - 5mg ,asacol - 12 tablets per day
Supplements:  multi-vit, calcium, folic acid
My wish:  get off prednsione....been on straight since 8/2006


flchurchlady
Veteran Member


Date Joined Jul 2007
Total Posts : 2765
   Posted 2/22/2008 6:26 PM (GMT -6)   
Chili,
That's great news that you're going to get some free supplies. When you feel nervous, try taking some deep breaths and watch a funny movie or TV show to try to take your mind off of it.
It's going to be okay. smurf

Shaz032 said...
Some companies won't cover supplies cos they class ostomy supplies as purely 'cosmetic' - apparently, they think they're the latest fashion accessory!

Oh my goodness, Shaz, you are so funny! tongue

Cece
Dx'd Crohn's in '99 at 28. Proctocolectomy and ileostomy in '06.
Disease-free, medicine-free, and very thankful to be healthy again :)


summerstorm
Veteran Member


Date Joined Aug 2006
Total Posts : 6571
   Posted 2/22/2008 9:20 PM (GMT -6)   
shaz that is a great idea!
somewhere i saw a woman who got her insurance to pay by claimning it like an amputeed part, like praying was saying. I don't know if that would work in your case or not. I would be really careful about buying on Ebay though, because you just never know how stuff was stored and taken care of.

praying4healing
Veteran Member


Date Joined Dec 2007
Total Posts : 739
   Posted 2/23/2008 7:16 PM (GMT -6)   
i'm glad u found some places to help. Mayb u may want to post some info in order to help others who might be in your same position. I'm so glad for the networking on this site. Everyone is great. I'm glad that weight is off of ur shoulders
25 y/o female- crohns disease since 14
Ileostomy pending-very worried
Tried asacol,pentasa,prednisone,remicade,6mp,azasan, no avail
Seatons placed
Worst year ever!

"For God has not given us the spirit of fear....."
Where does mine come from?!
 
Temp Ileostomy performed 1/29/08
Still Adusting
 
Healingwell.com has been my Godsend...Thank you


chili123
Regular Member


Date Joined Jan 2007
Total Posts : 300
   Posted 2/23/2008 9:48 PM (GMT -6)   
Community Action Agency is the one that is local. This is the one that offers the supplies without charging the postage etc b/c they are local so I can just go pick them up. The other place is and the other is ostogroup. Ostogroup is the one that charges 10% plus shipping but it sounds like you can be more specific to what you what.....or that is what I am thinking. Plus, there have also been some members on jpouch.org that have offered to give me their ostomy supplies that they nolonger need because they now have a pouch. Everyone has been really nice.
Pancolitis - July 2006
Medications:  Predisone - 5mg ,asacol - 12 tablets per day
Supplements:  multi-vit, calcium, folic acid
My wish:  get off prednsione....been on straight since 8/2006

New Topic Post Reply Printable Version
Forum Information
Currently it is Thursday, October 19, 2017 2:21 PM (GMT -6)
There are a total of 2,884,335 posts in 316,479 threads.
View Active Threads


Who's Online
This forum has 157602 registered members. Please welcome our newest member, Heleneddworr.
428 Guest(s), 13 Registered Member(s) are currently online.  Details
alephnull, RedLabel, 07kr5, island time, Pirouette, getting by, Brook58, gabybee, Yellow Cat, InTheShop, AZ Guy, fiddlecanoe, garyDouglas


Follow HealingWell.com on Facebook  Follow HealingWell.com on Twitter  Follow HealingWell.com on Pinterest
Advertisement
Advertisement

©1996-2017 HealingWell.com LLC  All rights reserved.

Advertise | Privacy Policy & Disclaimer