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What do basic ostomy supplies cost and how much does insurance pick up?

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Ostomies
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Posted 3/22/2013 10:34 PM (GMT 0)
I havent even checked my insurance but I like to keep in the back of my mind worst case scenarios, eg both I and my wife are suddenly unemployed or something... I.e. what does ostomy life cost, in absolute terms and how much do most good plans cover? (All, much, or just a little?) I am betting insurance doesnt cover a single penny of the "nice to have" junk and gizmos like belts and special underwear etc but hopefully, perhaps, it is at least elgible for FSA usage (For non-Americans that is a non-taxable fund you set aside for such things).
Posted 3/23/2013 12:29 AM (GMT 0)
It's highly dependent upon your plan. If you check with your insure company, they are considered "durable" goods and not prescriptions.

I have seen ten packs of bags range from like 60 for a box of ten to 350 for a box of ten (this was a highly specialized type for injured ostomy skin). If you do a two piece, I'm guessing 100 for a box of five wafers and 150 for a box of ten bags (these are middle of the road bags, velcro closure, no venting).

You can check out edgepark.com, that will give you an idea on cost.

My insurance pays "most" of the cost. I hit my deductible relatively early in the year, so didn't pay for supplies immediately after my surgery.
Posted 3/23/2013 1:12 AM (GMT 0)
My insurance covers 90% of the cost of supplies. My co-pay last month was $19.60, so I guess what I got is $196 retail -- that's 20 wafers, 20 pouches, 20 barrier rings, and a box of 50 adhesive remover wipes (I have SO MANY boxes of adhesive remover wipes that I don't even use, but the horrible mail order pharmacy -- Byram -- keeps "forgetting" to remove them from my order).
Posted 3/23/2013 7:12 PM (GMT 0)
everyone's insurance is different.
Call you insurance company and ask what the coverage is for "durable medical supplies"
Posted 3/23/2013 7:25 PM (GMT 0)
I'm guessing it costs less than mountains of probiotics, worms etc. I don't know how it works there but would medicare or medicaid cover it if you can't due to unemployment? It's unfathomable to me that people might be left without ostomy supplies because they can't afford them.
Posted 3/24/2013 12:32 AM (GMT 0)
With my insurance plan, I have to pay 25%. That usually amounts to around $80 a month on my end. Each month I usually get 20 wafers, 20 pouches, 20 Eakins, 20 EZ vents and miscellaneous barrier and adhesive remover wipes. I can occasionally skip a month as I end up with leftover supplies from other months. Ostomy supplies are so expensive. A box of 20 Eakin Rings is a little over $100 pre-insurance!
Posted 3/27/2013 1:03 AM (GMT 0)
I spent $2077.82 in total in 2012. $1200 of that is covered by my insurance, and another $600 is covered by government disability credit, so I'm out of pocket $277.82. That's here in Ontario, Canada. I have a usual 4 day weartime, and use Hollister new image 2 piece, hollister paste, cavilon spray, and powder at every change.

Matt
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