No ostomy supplies coverage

answers4me2

Veteran Member

Joined : Dec 2008

Posts : 1339

Posted 11/27/2023 6:25 PM (GMT 0)

I have had an ileostomy for 13 years. I had BCBS but this year we had to switch to United healthcare. I got my last order in July and only half the supplies then.

They will not cover m9 drops or adhesive removers or skin barrier protection wipes or sprays.

They are saying I can get 20 wafers every 90 days!!!! What. I need 20 a month.

They are also saying I have to pay out of pocket for the supplies and they will reimburse me. I have met my deductible 100% this year, so how could that be?

I'm almost out of supplies and I don't know what to do. I called the insurance company and they had no idea what an ileostomy or a wafer even was.

I left my doctor a message .

I looked to order supplies on Craigslist or Amazon and they are very expensive.

Any advice?

clo2014

Veteran Member

Joined : Feb 2015

Posts : 2324

Posted 12/1/2023 6:00 PM (GMT 0)

In the short term.... Call companies and ask for samples of any products you haven't used. Research ostomy support groups... See if they have members that donate or share their excess supplies. Read your insurance brochure and see what it states in it. They should follow the Medicare guidelines of 20 bags per month unless they have it in their brochure as an exception...(Medicare guidelines are on the internet) Call the insurance company and request a manager...keep escalating until you get someone that knows what they are speaking about. Call your state insurance regulator to make a complaint.

Where did you get your insurance from... Work? Internet? Agent?

Clo

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