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Law Educator, Esq.
Law Educator, Esq., Attorney
Category: Legal
Satisfied Customers: 111450
Experience:  JA Mentor -Attorney Labor/employment, corporate, sports law, admiralty/maritime and civil rights law
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Can Medicare take the omnipod tubeless insulin pump away

Customer Question

Can Medicare take the omnipod tubeless insulin pump away from my bennifets
Submitted: 1 year ago.
Category: Legal
Expert:  Law Educator, Esq. replied 1 year ago.

Thank you for your question. I look forward to working with you to provide you the information you are seeking for educational purposes only.

They can refuse to pay for certain types of equipment if there are other types of covered equipment that would satisfy your medical need. They do not have to pay for specific types of equipment if other equipment is available. If this is the only pump that will work for you, then your medical provider must write an appeal letter to medicaid explaining why no other type of pump will work in your situation. If medicaid denies your second level appeal, you are entitled to a third written appeal which they send to an outside company to review. Finally, if they deny the third level appeal, you are then entitled to a hearing before an administrative hearing officer to present your case from your doctor as to why this pump is necessary for a decision.