HealingWell
Search Close Search
☰

Supplies, No insurance.

Support Forums
>
Ostomies
✚ New Topic ✚ Reply
12
❬ ❬ Previous Thread |Next Thread ❭ ❭
Posted 11/14/2012 6:47 AM (GMT 0)
Hi everyone,

I am very new to having an ostomy. I had my surgery on October 12, 2012. I recently found out that my insurance (UHC) does not cover any of my ostomy supplies. I have begun my search to find affordable supplies but sheesh! They can get pretty expensive. I tried ostogroup.org (which is an amazing website) but they are out of stock and this is pretty much the only website I can afford. Does anyone know any other websites like this one? Or have any suggestions on another brand that is similar to the supplies I am using? I currently use the Coloplast SenSura Convex Light, One Piece Drainable, Cut to Fit 5/8'' to 1 3/4". Or any ideas where I can get affordable supplies? I found out my insurance doesn't cover much and my medical bills keep adding up and I do not qualify for state assistance. I'm worried that I will not be able to afford these supplies and I am not sure what I am going to do.

I am happy to have found this website... I always feel like I have so many "dumb" questions and its reassuring that I am not going through this alone.

 

Posted 11/14/2012 7:59 AM (GMT 0)
You can try your local ostomy support group and even your local hospitals. Sometimes they will donate unused supplies that are about to expire.
Posted 11/14/2012 8:02 AM (GMT 0)
Also, where do you live? I may be able to snatch up some stuff at the next meeting.
Posted 11/14/2012 8:04 AM (GMT 0)
I won't be able to make it to the support group this month because of work but I do plan on being there next month! and I am in Gilbert, AZ. :)
Posted 11/14/2012 12:25 PM (GMT 0)
I will have a bunch of extra leftover supplies soon and was looking for someone without insurance coverage to mail them to so they don't go to waste. It's Coloplast convex 2-piece drainable system so would probably work for you - some moldable some not, with all the fun wipes, pastes, etc. to go with. What size is your stoma?
Posted 11/14/2012 12:55 PM (GMT 0)
We have uhc, and mine are covered but they aren't listed how you think they would be. Did youactually call the insurrance company? I have seen some posts where people were able to getsupplies covered as prosthetics. You can buy stuff off ebay, but I would be wary of wafers because you don't know how they have been stored. Good luck.
Posted 11/14/2012 2:50 PM (GMT 0)
try calling the supplier, coloplast in your case, directly and see if they have some kind of financial assistance program.
Posted 11/14/2012 3:22 PM (GMT 0)
Please double check as ostomy supplies come under the heading of "Durable Medical Equipment" (DME) and not under your prescription drug coverage. It seems bizarre that they are not covered in some shape or form...maybe with a copay but outrageous that they would not be covered at all.

Let us know the end result as others (myself included) may be able to send stuff your way.
Posted 11/14/2012 4:19 PM (GMT 0)
arox
How soon will you need supplies? I am sure we can help.

Dan
Posted 11/14/2012 6:02 PM (GMT 0)
@bootstrap, Anything you could send my way would be amazing. My stoma is 1 3/4".

@summerstorm, I actually received a call from edgepark saying my insurance was not covered and the order my nurse put in for me would be cancelled. I immediately called UHC and they stated whether or not I had a prescription for the supplies they would not be covered under my plan. I didn't think of ebay, but I will be sure to check then out. Thank you!


@ddd45 I checked the coloplast website and it doesn't seem like I can order directly from them and when I called my nurse this morning she informed me to order supplies from edgepark.

@another uc wife I contacted UHC again this morning hoping that I asked the wrong questions. But unfortunately I was right. My employer did not select a plan that covers ostomy products.

@polishdan I have supplies for approximately 9 days or so. And thank you...

You guys are all amazing. I am so happy to have stumbled upon this forum.
Posted 11/14/2012 6:27 PM (GMT 0)
arox
1 3/4 inch stoma??? WOW
You said that you are wearing a convex wafer. Do you need convexity or is that what the hospital had handy?

Dan
Posted 11/14/2012 6:42 PM (GMT 0)
arox
You need to put your phone number on your profile. We can call you for your address. Not on a post. On your profile it will only be available to members.
As others said, did you ask about prosthetics and durable medical medical equipment?

Dan
Posted 11/14/2012 6:48 PM (GMT 0)
@polishdan I do need the convexity. My stoma does not protrude far enough out of my skin. Is 1 3/4 big? I was cutting the wafer 1 1/8 but WOC nurse said I needed to be cutting it a little bigger. And yes I asked about prosthetics and durable medical equipment but UHC states it is listed under prescriptions. And that some plans do cover it, just not the plan my employer has chosen. And I will be updating my phone number.
Posted 11/14/2012 6:52 PM (GMT 0)
@polishdan I'm not sure where I'm supposed to update my phone number... My email is [email protected]
Posted 11/14/2012 7:08 PM (GMT 0)
arox
I didn't know you cannot post phone numbers on your profile. E-mail is good. However, it is better to put it on your profile than in a post because of spammers.

Dan
Posted 11/14/2012 8:53 PM (GMT 0)
Amy, I am writing you an email.
Posted 11/14/2012 10:45 PM (GMT 0)
arox-
Yes, 1 3/4 is big. If you were originally cutting 1 1/8, then going from that to 1 3/4 is a very big change... A couple questions:

1) Does that new size leave too much room around the edge - is there skin exposed around your stoma when you put it on?

2) Is your stoma still shrinking at all from surgery, or has it settled in at one size?

I have some fixed-size, non-cuttable that are 1 1/8 (that's what I left the hospital with but they are now too big for me) and some moldable ones that will fit stoma sizes anywhere between 7/8 and 1 1/4. If you think these will be too small I can send them somewhere else, but from the sounds of it they might work depending on the actual size of your stoma and whether it's still shrinking.

If you think it will work then email me your mailing address and phone number so I can call/text if I have any additional questions, and I will send you whatever I can. (My email is listed in my profile.) My ileo reversal is December 11, so that's when I'll be dumping all my leftovers, but I can probably send some stuff sooner since I think I'll be changing systems in the next couple days - just spoke with a ConvaTec nurse who said the moldable ones aren't a good recommendation for me because of the way my stoma moves around and retracts at times. (I might even be able to order a few extra supplies before my reversal since it is all covered by insurance.)

If you only have enough for nine days or so, I can mail some of this stuff out right away if I know whether it will work for you (with your stoma size) and then get the rest out to you later after my other supplies come in. Let me know....
Posted 11/14/2012 11:20 PM (GMT 0)
Amy can you call your employer at all...the HR dept or whomever handles the insurance end of things for your company? I suggest this as maybe they can get something like this added to the policy or at the very least for the next contract renewal. I find this to be more of an oversight type thing as it is unconscionable to NOT provide for ostomy supplies in any manner, shape or form.

I was very surprised to learn initially they are under the durable medical equipment category.

My husband has a very small stoma and the supplies we have I don't think would allow for that circumferance. I am wondering if yours will be shrinking some more too. I am going to check anyway to see if there is anything that I can contact you about.

There are many suppliers other than Edgepark who I think may be on the more expensive side even if you were to do a discounted private pay set up with them. ???Parthenon??? if I am rembering right might be the name of a company that is more reasonably priced? I am sure someone will chime in with some additional info.

And yes sometimes ebay.

A definite local support group is an excellent way to possibly get supplies. We have a support group that we went to the first meeting in Sept and several people brought supplies for anyone who could have used them.
Posted 11/14/2012 11:31 PM (GMT 0)
ok Amy...I just checked and hubby is a "cut to fit" 5/8" - 1 3/4" so the size would be ok...he uses the SenSura #15606 convex light EasiClose WIDE outlet maxi/standard wear/transparent one piece unit with the velcro closure. This type has NO outer adhesive. It stays on his skin perfectly fine with just using a light application of skin prep.

If these would be something you would use I can send you some. Don't want to send if it something you will not or don't care to use. Just let me know and I'll e-mail you for your address. Let us know other supplies you use too in case any of us have some of those we can send too....eakin seals, skin prep pads, adhesive remover pads.....etc.
Posted 11/14/2012 11:43 PM (GMT 0)
I see you had surgery Oct 12 so your size will be changing over the next couple of months - I was 1 1/8 straight out of surgery and now am a little under 7/8. Also try the WOCN group in your area - there usually is one especially if you have an ostomy support group. I am in San Antonio and one of our hospitals here has a "cancer closet" with ostomy supplies for people who have colon cancer, etc.
Posted 11/15/2012 12:08 AM (GMT 0)
arox
Call your insurance company again. When you hear "no coverage" ask to talk to a supervisor. Insist! It can be surprising how different answers can be from a supervisor. And if necessary go up the management chain. The squeaky wheel gets the grease.

Dan
Posted 11/15/2012 12:31 AM (GMT 0)
@b'dereh Great! :)

@bootstrap There is some skin exposed around the edge of the stoma. I am not sure why the nurse would tell me to cut it bigger... And It still seems to be shrinking, it was much, much bigger when I first left the hospital. Anything you send would be extremely appreciated. I will be sending you an email soon.

@another uc wife I did reach out to our benefits person and she wasn't very helpful. She said I needed to contact UHC and go off what they say. She mentioned that the plans for the upcoming year where the same and they were not going to be adding any type of additional coverages. My ileo is only til February so there are only 3 more months of having to worry about supplies, I hope. And I use the 15606 as well. Any he could spare would be so appreciated. And I don't use anything else... my nurse said the less, the better. So I am not familiar with any other products. My nurse is a very sweet lady but she doesn't seem to knowledgeable when it comes to ostomies.

@allbluezoo I did reach out to the Ostomy Clinic in my area and they did assist me with changing from a flat wafer to a convex wafer. I did ask if she knew where I could purchase discounted prodcuts and that is when she referred me to my local ostomy group. Unforunately, their meeting is this Sunday and it is during the time I work.

@polishdan I definitely should! I will try again tomorrow morning, the worse thing they could say is no, right? And that's where I currently am!
Posted 11/15/2012 1:29 AM (GMT 0)
arox
I have some flat one piece w/cut to fit wafers, not convex. I also have some eakin seals that can work in place of convexity. They are drainable with a clip. If you don't get a better offer I will ship them to you.

The problem is needing convexity with such a large sroma. My garden hose isn't that big.

Dan
Posted 11/15/2012 1:36 AM (GMT 0)
Ok...riddle me this and don't mean to be a smart ***...but ask your insurance people....how do you approve and pay for an operation that REQUIRES these type of supplies for aftercare... so why is the surgery allowed then????? I'd press for an answer on that for darn sure. This has my blood boiling.

I will e-mail you for your address and get some out to you.
Posted 11/15/2012 1:41 AM (GMT 0)
Oh in that case it sonds like my supplies will work perfectly for you then. I'll send you enough stuff to hold you for a good while, along with all the extra goodies (deoderizer drops, paste, belt, alcohol swabs for removals, etc.) And then will send you a bunch more at my takedown if your stoma ends up around the size of mine. Depending on how often you change and whether my new supplies fit you, it could *possibly* even last you until takedown.

Will try to get it in the mail by tomorrow.
✚ New Topic ✚ Reply
12