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Posted 12/18/2008 8:16 PM (GMT 0)
My insurance company, UHC, has denied reimbursement for my ostomy supplies. I plan to appeal, but am so frustrated. How can they deny supplies that are necessary for me to live? Does anyone else have experience or advice with this? Your help is much appreciated.
Posted 12/18/2008 9:49 PM (GMT 0)
Insurance companies don't view ostomy supplies as necessary for life. about 8 years ago some insurance companies began eliminating or reducing coverage to these supplies and I suspect more will follow suit. When I had a temp ostomy my insurance company covered about 60--80% as I recall and that was about 7 years ago.
It doesn't seem fair since they seem to have no problem handing viagra out to any man who asks for it but deny women birth control pills? Don't get me started.

Sue
Posted 12/19/2008 12:54 AM (GMT 0)

suebear said...
Insurance companies don't view ostomy supplies as necessary for life. about 8 years ago some insurance companies began eliminating or reducing coverage to these supplies and I suspect more will follow suit. When I had a temp ostomy my insurance company covered about 60--80% as I recall and that was about 7 years ago.
It doesn't seem fair since they seem to have no problem handing viagra out to any man who asks for it but deny women birth control pills? Don't get me started.

Sue


This is a major reason why people want national health care.

Health insurance companies only want people who are well and don't need medical care.

If you've got a cold and sniffles, they'll bend over backwards for ways to deny paying any claims.

(getting off the soapbox)
Posted 12/19/2008 2:28 AM (GMT 0)
someone managed to get their supplies paid for by having it considered prothestics, like for an amputee.
Posted 12/19/2008 8:25 AM (GMT 0)
Back in the early 80's, I can remember that ostomy supplies were definitely covered BUT were listed as prosthetics. You might try that. I can't hardly believe that they would deny coverage. I can see that they might limit the quanity, and that is reasonable. But to deny, that is unreasonable.
Posted 12/19/2008 4:14 PM (GMT 0)
That is ridiculous! How do they expect us to live without our appliances?! confused

I recommend calling your insurance company and asking them if they have a contract with any suppliers. I found out (by asking) that my insurance company has a contract with Sterling Medical to cover my supplies by 100%, but they don't have that deal with other suppliers.

Good luck!
Posted 12/20/2008 2:10 AM (GMT 0)
Thanks for the suggestions!
Posted 12/20/2008 3:03 AM (GMT 0)
I have UHC and mine are covered 80/20...it may be the plan you are in...check into other ones provided by your employer when open enrollement comes around. One of them may cover ostomy supplies! Good Luck:)
Posted 12/29/2008 2:01 AM (GMT 0)
i had UHC until 12/1> It paid 100% of all items from Edgepark
Posted 12/29/2008 8:11 PM (GMT 0)
Ok, so some more details:

The UHC policy at my hub's employment specifies in it's certificate of coverage that it will not cover disposable medical supplies such as ostomy supplies. It will cover prescribed prosthetics. I have been ordering through Edgepark, who has an rx from my surgeon, and who unsuccessfully billed UHC.

Anyone know how to get it billed as prosthetics -- I'm guessing that Edgepark is already doing that, but should probably make sure...
Posted 12/30/2008 1:02 PM (GMT 0)
Maybe contact Edgepark's billing office and talk directly to them. Maybe they can bill it under a different "code" as a prosthetic for you?
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