Vest being denied by insurance....

[Kelli]

OK, so I got a new vest last year because I had my original vest from 16 years ago. So the setting weren't correct (weren't strong enough), it was old, it was a beast, it was huge, it needed replaced.

So I got a bill today for nearly $2,000 because insurance (secondary not Medicare) is stating that it wasn't necessary and simply says "I should not have gotten a new vest just so it'd be smaller." Not medically necessary.

I KNOW somewhere, I have info that states since my vest was SO OLD, I was due to get a new one and that upgrade should be covered at no cost.

Can anyone help me with this?!

 

[Kelli]

OK, so I got a new vest last year because I had my original vest from 16 years ago. So the setting weren't correct (weren't strong enough), it was old, it was a beast, it was huge, it needed replaced.

So I got a bill today for nearly $2,000 because insurance (secondary not Medicare) is stating that it wasn't necessary and simply says "I should not have gotten a new vest just so it'd be smaller." Not medically necessary.

I KNOW somewhere, I have info that states since my vest was SO OLD, I was due to get a new one and that upgrade should be covered at no cost.

Can anyone help me with this?!

 

[Kelli]

OK, so I got a new vest last year because I had my original vest from 16 years ago. So the setting weren't correct (weren't strong enough), it was old, it was a beast, it was huge, it needed replaced.

So I got a bill today for nearly $2,000 because insurance (secondary not Medicare) is stating that it wasn't necessary and simply says "I should not have gotten a new vest just so it'd be smaller." Not medically necessary.

I KNOW somewhere, I have info that states since my vest was SO OLD, I was due to get a new one and that upgrade should be covered at no cost.

Can anyone help me with this?!

 

[Kelli]

OK, so I got a new vest last year because I had my original vest from 16 years ago. So the setting weren't correct (weren't strong enough), it was old, it was a beast, it was huge, it needed replaced.

So I got a bill today for nearly $2,000 because insurance (secondary not Medicare) is stating that it wasn't necessary and simply says "I should not have gotten a new vest just so it'd be smaller." Not medically necessary.

I KNOW somewhere, I have info that states since my vest was SO OLD, I was due to get a new one and that upgrade should be covered at no cost.

Can anyone help me with this?!

 

[Kelli]

OK, so I got a new vest last year because I had my original vest from 16 years ago. So the setting weren't correct (weren't strong enough), it was old, it was a beast, it was huge, it needed replaced.
<br />
<br />So I got a bill today for nearly $2,000 because insurance (secondary not Medicare) is stating that it wasn't necessary and simply says "I should not have gotten a new vest just so it'd be smaller." Not medically necessary.
<br />
<br />I KNOW somewhere, I have info that states since my vest was SO OLD, I was due to get a new one and that upgrade should be covered at no cost.
<br />
<br />Can anyone help me with this?!

 

[Skye]

I would call the vest company and see if they can help in some way with your argument that it was indeed time for a new one. Also, the vest company should be able to help you set up a payment plan on the 2,000. I don't understand what the 2,000 is.....the vest is a lot more than that so they are paying for some part of it. Is that your deductible or your cost after Medicare has paid? I hope you can get this worked out...good luck.

 

[Skye]

I would call the vest company and see if they can help in some way with your argument that it was indeed time for a new one. Also, the vest company should be able to help you set up a payment plan on the 2,000. I don't understand what the 2,000 is.....the vest is a lot more than that so they are paying for some part of it. Is that your deductible or your cost after Medicare has paid? I hope you can get this worked out...good luck.

 

[Skye]

I would call the vest company and see if they can help in some way with your argument that it was indeed time for a new one. Also, the vest company should be able to help you set up a payment plan on the 2,000. I don't understand what the 2,000 is.....the vest is a lot more than that so they are paying for some part of it. Is that your deductible or your cost after Medicare has paid? I hope you can get this worked out...good luck.

 

[Skye]

I would call the vest company and see if they can help in some way with your argument that it was indeed time for a new one. Also, the vest company should be able to help you set up a payment plan on the 2,000. I don't understand what the 2,000 is.....the vest is a lot more than that so they are paying for some part of it. Is that your deductible or your cost after Medicare has paid? I hope you can get this worked out...good luck.

 

[Skye]

I would call the vest company and see if they can help in some way with your argument that it was indeed time for a new one. Also, the vest company should be able to help you set up a payment plan on the 2,000. I don't understand what the 2,000 is.....the vest is a lot more than that so they are paying for some part of it. Is that your deductible or your cost after Medicare has paid? I hope you can get this worked out...good luck.

 

[ladybug]

I had also been told any upgrade was not covered just cause I wanted the 104 model when it came out. <img src="i/expressions/face-icon-small-sad.gif" border="0"> I had to get a letter of medical necessity stating needs for it to be smaller for travel, etc. and somehow that worked to get it covered, but it did entail a lot of work on my part and fighting with my insurance(s). BCBS, who had covered the original vest said the same thing, "we're not going to do it just for convenience to you. there has to be a medical reason or something they've done to better the new vest." luckily, i fought and fought with them and got that doctor's letter and they did cover MOST of it. then, my secondary insurance picked up the rest. i think it was like $6,000 extra to "upgrade", so i agree they must be covering something if you're only getting charged $2,000.

good luck. i know its a hassle. i wish when vets get smaller and more convenient, they would change something else that makes it better medically so we could prove its more effective than the old one. convenience isn't enough for insurance agencies. <img src="i/expressions/face-icon-small-sad.gif" border="0">

 

[ladybug]

I had also been told any upgrade was not covered just cause I wanted the 104 model when it came out. <img src="i/expressions/face-icon-small-sad.gif" border="0"> I had to get a letter of medical necessity stating needs for it to be smaller for travel, etc. and somehow that worked to get it covered, but it did entail a lot of work on my part and fighting with my insurance(s). BCBS, who had covered the original vest said the same thing, "we're not going to do it just for convenience to you. there has to be a medical reason or something they've done to better the new vest." luckily, i fought and fought with them and got that doctor's letter and they did cover MOST of it. then, my secondary insurance picked up the rest. i think it was like $6,000 extra to "upgrade", so i agree they must be covering something if you're only getting charged $2,000.

good luck. i know its a hassle. i wish when vets get smaller and more convenient, they would change something else that makes it better medically so we could prove its more effective than the old one. convenience isn't enough for insurance agencies. <img src="i/expressions/face-icon-small-sad.gif" border="0">

 

[ladybug]

I had also been told any upgrade was not covered just cause I wanted the 104 model when it came out. <img src="i/expressions/face-icon-small-sad.gif" border="0"> I had to get a letter of medical necessity stating needs for it to be smaller for travel, etc. and somehow that worked to get it covered, but it did entail a lot of work on my part and fighting with my insurance(s). BCBS, who had covered the original vest said the same thing, "we're not going to do it just for convenience to you. there has to be a medical reason or something they've done to better the new vest." luckily, i fought and fought with them and got that doctor's letter and they did cover MOST of it. then, my secondary insurance picked up the rest. i think it was like $6,000 extra to "upgrade", so i agree they must be covering something if you're only getting charged $2,000.

good luck. i know its a hassle. i wish when vets get smaller and more convenient, they would change something else that makes it better medically so we could prove its more effective than the old one. convenience isn't enough for insurance agencies. <img src="i/expressions/face-icon-small-sad.gif" border="0">

 

[ladybug]

I had also been told any upgrade was not covered just cause I wanted the 104 model when it came out. <img src="i/expressions/face-icon-small-sad.gif" border="0"> I had to get a letter of medical necessity stating needs for it to be smaller for travel, etc. and somehow that worked to get it covered, but it did entail a lot of work on my part and fighting with my insurance(s). BCBS, who had covered the original vest said the same thing, "we're not going to do it just for convenience to you. there has to be a medical reason or something they've done to better the new vest." luckily, i fought and fought with them and got that doctor's letter and they did cover MOST of it. then, my secondary insurance picked up the rest. i think it was like $6,000 extra to "upgrade", so i agree they must be covering something if you're only getting charged $2,000.

good luck. i know its a hassle. i wish when vets get smaller and more convenient, they would change something else that makes it better medically so we could prove its more effective than the old one. convenience isn't enough for insurance agencies. <img src="i/expressions/face-icon-small-sad.gif" border="0">

 

[ladybug]

I had also been told any upgrade was not covered just cause I wanted the 104 model when it came out. <img src="i/expressions/face-icon-small-sad.gif" border="0"> I had to get a letter of medical necessity stating needs for it to be smaller for travel, etc. and somehow that worked to get it covered, but it did entail a lot of work on my part and fighting with my insurance(s). BCBS, who had covered the original vest said the same thing, "we're not going to do it just for convenience to you. there has to be a medical reason or something they've done to better the new vest." luckily, i fought and fought with them and got that doctor's letter and they did cover MOST of it. then, my secondary insurance picked up the rest. i think it was like $6,000 extra to "upgrade", so i agree they must be covering something if you're only getting charged $2,000.
<br />
<br />good luck. i know its a hassle. i wish when vets get smaller and more convenient, they would change something else that makes it better medically so we could prove its more effective than the old one. convenience isn't enough for insurance agencies. <img src="i/expressions/face-icon-small-sad.gif" border="0">

 

[Skye]

I don't know if this has anything to do with things; but, I seem to remember this somewhere. I WISH that the vest companies would not provide a lifetime guarantee. I am not sure; but, I think that is part of the problem. My insulin pumps warranty runs out after 4 years and I automatically get a new one....no probs.

 

[Skye]

I don't know if this has anything to do with things; but, I seem to remember this somewhere. I WISH that the vest companies would not provide a lifetime guarantee. I am not sure; but, I think that is part of the problem. My insulin pumps warranty runs out after 4 years and I automatically get a new one....no probs.

 

[Skye]

I don't know if this has anything to do with things; but, I seem to remember this somewhere. I WISH that the vest companies would not provide a lifetime guarantee. I am not sure; but, I think that is part of the problem. My insulin pumps warranty runs out after 4 years and I automatically get a new one....no probs.

 

[Skye]

I don't know if this has anything to do with things; but, I seem to remember this somewhere. I WISH that the vest companies would not provide a lifetime guarantee. I am not sure; but, I think that is part of the problem. My insulin pumps warranty runs out after 4 years and I automatically get a new one....no probs.

 

[Skye]

I don't know if this has anything to do with things; but, I seem to remember this somewhere. I WISH that the vest companies would not provide a lifetime guarantee. I am not sure; but, I think that is part of the problem. My insulin pumps warranty runs out after 4 years and I automatically get a new one....no probs.