Type 1 - Connect

HI all, 

 I am looking for some tips on how to handle my insurance situation relating to my pump upgrade. 

I got Type 1 diabetes quite late in live and only been on a pump for 8 years now. I initially was on the Metronic for 4 years and then changed in May 2020 to the Solo pump from Roche was the first patch pump that came to Australia. I had my ups and downs with it, but after 3 years, I am not able to continue with it. 

The Solo as a consumable has a yearly approval. And I had no problems getting this every year. Since March 2023 I have considered changing to a new pump. 

I called BUPA and asked if I need to do another 1 year with SOLO or if I could change to a new pump from May onwards when my 3rd year was over. They said, as it's a consumable, it was not a problem to change after the year. 

Then I applied via the hospital in July for the new pump upgrade and 1 months later got a decline for the pump upgrade, because they approve this only every 4 years and my last pump was given to me in May 2022. 

I have had 6 calls with BUPA now since I got the decline on the 22nd of August. I only every get  to the call center. :-( They dont understand a word about insulin pumps.  During the first call they talked to the hospital team and said, yes you are right sorry, we will change the approval letter. You will get this within 7 working days (it's not 25 working days !). 

Every since they have said, oh... it will just take a few more days, then somethings like you should wait 2 years and then oh now we approved your other pump. So clearly the people I talk to have no clue. The case managers at BUPA are not moving. 

However, my consumable pump will run out in 50 days and then I will have no pump :-)

Any tips on what to do with BUPA or my pump upgrade? I would not like to go back to injections.

Thanks

Stefanie

HI all, 

 I am looking for some tips on how to handle my insurance situation relating to my pump upgrade. 

I got Type 1 diabetes quite late in live and only been on a pump for 8 years now. I initially was on the Metronic for 4 years and then changed in May 2020 to the Solo pump from Roche was the first patch pump that came to Australia. I had my ups and downs with it, but after 3 years, I am not able to continue with it. 

The Solo as a consumable has a yearly approval. And I had no problems getting this every year. Since March 2023 I have considered changing to a new pump. 

I called BUPA and asked if I need to do another 1 year with SOLO or if I could change to a new pump from May onwards when my 3rd year was over. They said, as it's a consumable, it was not a problem to change after the year. 

Then I applied via the hospital in July for the new pump upgrade and 1 months later got a decline for the pump upgrade, because they approve this only every 4 years and my last pump was given to me in May 2022. 

I have had 6 calls with BUPA now since I got the decline on the 22nd of August. I only every get  to the call center. :-( They dont understand a word about insulin pumps.  During the first call they talked to the hospital team and said, yes you are right sorry, we will change the approval letter. You will get this within 7 working days (it's not 25 working days !). 

Every since they have said, oh... it will just take a few more days, then somethings like you should wait 2 years and then oh now we approved your other pump. So clearly the people I talk to have no clue. The case managers at BUPA are not moving. 

However, my consumable pump will run out in 50 days and then I will have no pump :-)

Any tips on what to do with BUPA or my pump upgrade? I would not like to go back to injections.

Thanks

Stefanie

Hi Stephanie

The brutal corporate approach seems to be the order of the day with corporate governance of our lives overtaking any semblance of freedom. The offshore call center charade is being used by many operatives to confuse, obfuscate and maximise profit... and it is working well. You just have to find a way to expose their malfeasance to the point where embarrassment may effect their bottom line.  

 I would be trying  an ombudsman. Maybe this one: https://www.health.gov.au/contacts/commonwealth-ombudsman-private-health-insurance?language=und  It is an insurance issue. In one unrelated instance with the banking ombudsman ,which was once under the same umbrella, a disaster was apologetically reversed in 1 hour(plus a token extra gift) after a phone call to that ombudsman. Be sure to tell the ombudsman how dangerous the situation is... in detail, stress that time is of the essence. They probably will ask you to contact BUPA to try to work it out and there may be a time lime that BUPA has to fix it. So explain, preferably also in writing, that they may be liable criminally and civilly if you have health issues due to their tardiness, etc.  If that does not work, call you fed MP and ask for advice on who to contact. That has worked too. In a situation where the MP said there was no governing body. He sent a note to the obstinate party and the problem vanished. 

I suggest that if you have a win you ask BUPA that seeing the problem was offshore and language was a problem, they give a direct number to an Aus case manager. Say that as this is a matter of acute safety, they have duty of care to supply an immediate helpline or they could be found to be malfeasant, misfeasant or nonfeasant. 

Please do not construe this as legal advice. It is simply what I would do in your position.

Please let us all know how you fair. It could be handy in the future.

HI all, 

 I am looking for some tips on how to handle my insurance situation relating to my pump upgrade. 

I got Type 1 diabetes quite late in live and only been on a pump for 8 years now. I initially was on the Metronic for 4 years and then changed in May 2020 to the Solo pump from Roche was the first patch pump that came to Australia. I had my ups and downs with it, but after 3 years, I am not able to continue with it. 

The Solo as a consumable has a yearly approval. And I had no problems getting this every year. Since March 2023 I have considered changing to a new pump. 

I called BUPA and asked if I need to do another 1 year with SOLO or if I could change to a new pump from May onwards when my 3rd year was over. They said, as it's a consumable, it was not a problem to change after the year. 

Then I applied via the hospital in July for the new pump upgrade and 1 months later got a decline for the pump upgrade, because they approve this only every 4 years and my last pump was given to me in May 2022. 

I have had 6 calls with BUPA now since I got the decline on the 22nd of August. I only every get  to the call center. :-( They dont understand a word about insulin pumps.  During the first call they talked to the hospital team and said, yes you are right sorry, we will change the approval letter. You will get this within 7 working days (it's not 25 working days !). 

Every since they have said, oh... it will just take a few more days, then somethings like you should wait 2 years and then oh now we approved your other pump. So clearly the people I talk to have no clue. The case managers at BUPA are not moving. 

However, my consumable pump will run out in 50 days and then I will have no pump :-)

Any tips on what to do with BUPA or my pump upgrade? I would not like to go back to injections.

Thanks

Stefanie

HI all, 

 I am looking for some tips on how to handle my insurance situation relating to my pump upgrade. 

I got Type 1 diabetes quite late in live and only been on a pump for 8 years now. I initially was on the Metronic for 4 years and then changed in May 2020 to the Solo pump from Roche was the first patch pump that came to Australia. I had my ups and downs with it, but after 3 years, I am not able to continue with it. 

The Solo as a consumable has a yearly approval. And I had no problems getting this every year. Since March 2023 I have considered changing to a new pump. 

I called BUPA and asked if I need to do another 1 year with SOLO or if I could change to a new pump from May onwards when my 3rd year was over. They said, as it's a consumable, it was not a problem to change after the year. 

Then I applied via the hospital in July for the new pump upgrade and 1 months later got a decline for the pump upgrade, because they approve this only every 4 years and my last pump was given to me in May 2022. 

I have had 6 calls with BUPA now since I got the decline on the 22nd of August. I only every get  to the call center. :-( They dont understand a word about insulin pumps.  During the first call they talked to the hospital team and said, yes you are right sorry, we will change the approval letter. You will get this within 7 working days (it's not 25 working days !). 

Every since they have said, oh... it will just take a few more days, then somethings like you should wait 2 years and then oh now we approved your other pump. So clearly the people I talk to have no clue. The case managers at BUPA are not moving. 

However, my consumable pump will run out in 50 days and then I will have no pump :-)

Any tips on what to do with BUPA or my pump upgrade? I would not like to go back to injections.

Thanks

Stefanie

HI all, 

 I am looking for some tips on how to handle my insurance situation relating to my pump upgrade. 

I got Type 1 diabetes quite late in live and only been on a pump for 8 years now. I initially was on the Metronic for 4 years and then changed in May 2020 to the Solo pump from Roche was the first patch pump that came to Australia. I had my ups and downs with it, but after 3 years, I am not able to continue with it. 

The Solo as a consumable has a yearly approval. And I had no problems getting this every year. Since March 2023 I have considered changing to a new pump. 

I called BUPA and asked if I need to do another 1 year with SOLO or if I could change to a new pump from May onwards when my 3rd year was over. They said, as it's a consumable, it was not a problem to change after the year. 

Then I applied via the hospital in July for the new pump upgrade and 1 months later got a decline for the pump upgrade, because they approve this only every 4 years and my last pump was given to me in May 2022. 

I have had 6 calls with BUPA now since I got the decline on the 22nd of August. I only every get  to the call center. :-( They dont understand a word about insulin pumps.  During the first call they talked to the hospital team and said, yes you are right sorry, we will change the approval letter. You will get this within 7 working days (it's not 25 working days !). 

Every since they have said, oh... it will just take a few more days, then somethings like you should wait 2 years and then oh now we approved your other pump. So clearly the people I talk to have no clue. The case managers at BUPA are not moving. 

However, my consumable pump will run out in 50 days and then I will have no pump :-)

Any tips on what to do with BUPA or my pump upgrade? I would not like to go back to injections.

Thanks

Stefanie

Hi Stafanie, I have been on a pump now for many years. Each time my renewal comes up I get a letter from my endo, then I contact the representative for the pump that I use. Next I contact my daibetic educator. This way the health fund knows you mean business,  All of your team know what is happening, I am with medibank and so far have not had a problem. I have a T-slim X2 & it is an excellent product. I also use Descom G6 & the two of them keep me running.

I hope my little bit of info helps.

Regards

HI all, 

 I am looking for some tips on how to handle my insurance situation relating to my pump upgrade. 

I got Type 1 diabetes quite late in live and only been on a pump for 8 years now. I initially was on the Metronic for 4 years and then changed in May 2020 to the Solo pump from Roche was the first patch pump that came to Australia. I had my ups and downs with it, but after 3 years, I am not able to continue with it. 

The Solo as a consumable has a yearly approval. And I had no problems getting this every year. Since March 2023 I have considered changing to a new pump. 

I called BUPA and asked if I need to do another 1 year with SOLO or if I could change to a new pump from May onwards when my 3rd year was over. They said, as it's a consumable, it was not a problem to change after the year. 

Then I applied via the hospital in July for the new pump upgrade and 1 months later got a decline for the pump upgrade, because they approve this only every 4 years and my last pump was given to me in May 2022. 

I have had 6 calls with BUPA now since I got the decline on the 22nd of August. I only every get  to the call center. :-( They dont understand a word about insulin pumps.  During the first call they talked to the hospital team and said, yes you are right sorry, we will change the approval letter. You will get this within 7 working days (it's not 25 working days !). 

Every since they have said, oh... it will just take a few more days, then somethings like you should wait 2 years and then oh now we approved your other pump. So clearly the people I talk to have no clue. The case managers at BUPA are not moving. 

However, my consumable pump will run out in 50 days and then I will have no pump :-)

Any tips on what to do with BUPA or my pump upgrade? I would not like to go back to injections.

Thanks

Stefanie

Hi all, 

Thank you so much for your replies and your help. I needed a weekend away from emails and the laptop. 

A few of the steps have been on my list already. Several others have been some good new ideas. 

It is quite a bit of a shame that with all the innovations around make our life easier, longer and a lot more normal. We are depending on the brutal corporate system. 

I will keep the community up to date with any progress and hopeful a good outcome soon. 

Best wsihes

Stefanie

Hi Stafanie, I have been on a pump now for many years. Each time my renewal comes up I get a letter from my endo, then I contact the representative for the pump that I use. Next I contact my daibetic educator. This way the health fund knows you mean business,  All of your team know what is happening, I am with medibank and so far have not had a problem. I have a T-slim X2 & it is an excellent product. I also use Descom G6 & the two of them keep me running.

I hope my little bit of info helps.

Regards

HI all, 

 I am looking for some tips on how to handle my insurance situation relating to my pump upgrade. 

I got Type 1 diabetes quite late in live and only been on a pump for 8 years now. I initially was on the Metronic for 4 years and then changed in May 2020 to the Solo pump from Roche was the first patch pump that came to Australia. I had my ups and downs with it, but after 3 years, I am not able to continue with it. 

The Solo as a consumable has a yearly approval. And I had no problems getting this every year. Since March 2023 I have considered changing to a new pump. 

I called BUPA and asked if I need to do another 1 year with SOLO or if I could change to a new pump from May onwards when my 3rd year was over. They said, as it's a consumable, it was not a problem to change after the year. 

Then I applied via the hospital in July for the new pump upgrade and 1 months later got a decline for the pump upgrade, because they approve this only every 4 years and my last pump was given to me in May 2022. 

I have had 6 calls with BUPA now since I got the decline on the 22nd of August. I only every get  to the call center. :-( They dont understand a word about insulin pumps.  During the first call they talked to the hospital team and said, yes you are right sorry, we will change the approval letter. You will get this within 7 working days (it's not 25 working days !). 

Every since they have said, oh... it will just take a few more days, then somethings like you should wait 2 years and then oh now we approved your other pump. So clearly the people I talk to have no clue. The case managers at BUPA are not moving. 

However, my consumable pump will run out in 50 days and then I will have no pump :-)

Any tips on what to do with BUPA or my pump upgrade? I would not like to go back to injections.

Thanks

Stefanie