Health Insurance Change - Ostomy Supplies Now Classified as Medical Supplies

Hello everyone,
This is my first post on this site, but I come here often and have gotten some really good information from some of you. I have had a colostomy for 10 years and up until recently, I have had my health insurance pick up either 100% of the cost of my supplies or at least half. Recently, my place of employment changed insurance companies and the new insurance company is billing my ostomy supplies under medical supplies instead of durable medical equipment. So, of course, now I have a $2,500 deductible I must meet before they pick up any of the cost of my supplies. I am now forced to pay full price for my supplies! Wow, they are outrageously priced! Does anyone know of any organizations to help with the cost of supplies? Or I wonder if I could get my local insurance commissioner involved. I have never heard of any insurance company calling ostomy supplies medical supplies; they have always been under the durable equipment category. I pay $275.00 every 2 weeks for health insurance for just myself. You would think I could at least get something paid towards my supplies. Any suggestions would be appreciated. Sandy

Well, I can't help with the insurance issue. But I can advise you to shop around for your ostomy supplies. Lots of places will give you a discount under what they charge the insurance company. I buy mine from RTA Medical Equipment. I buy enough at one time to get free shipping. My total cost for a year's supply is a little under $1000 or about $3 a day. I figure I can save that much by taking my lunch and cokes to work.

Thanks... I will check on the RTA Medical Company.

Hello Sandy. I think that I would go to my employer and explain about how the change of insurance companies has affected me.  If they don't know that this company is that much worse at paying out than the last one they won't know that they should perhaps think twice.  You never know, they might change back again! The problem is that they are likely to be saving money on premiums - at your expense.

Best wishes Bill

Hi Sandy,

If you need cheap but honest, there is a new company out of Phoenix. His name is Scott Amiot and he sells Convatec and Hollister products. His email address is ****. (602) 790-3335. Try him. He should be very reasonable. Yepper.

How to Manage Ostomy Leaks with LeeAnne Hayden | Hollister

Sandy, check into ObamaCare when it comes around. I think it will pay for supplies and be a lot cheaper for you!

Yance, I sure hope you are right. I know how devastatingly expensive these supplies are and I am deeply grateful that Medicare and my own secondary insurance cover the cost...right now, anyway. I am curious, however, why you think the Affordable Healthcare Act (Obamacare) will help Sandy in any significant way since she already has her own health insurance, albeit quite limited. Is the wish perhaps "father to the thought" or can you be more explicit. Thanks.
       PB

Good luck on that! If anything, it's going to cost you more!

I've had an ostomy for 44 years, and when I first started buying these glorified plastic bags, they cost me $7 a box of 30.
Now I'm paying $35.00 a box of 5.
The manufacturer is making a killing on these, and if you're lucky to have insurance, they are paying these money grabbers for you. This is where the government ought to be investigating anyone who takes advantage of people that need medical supplies and getting the cost down!

Lol....you have that backwards. Because of the govt.....medical items are higher...and anything else they "regulate".

Anyone who thinks the federal govt can "help them out"...should examine the American Indian.........

Hi Sandy: I have a colostomy, have had it since December 2011. I just got insurance within the last month, so I have been paying out of pocket for my supplies. I have found that dealing with these large supply companies, i.e. Edgepark, Liberator, etc., is quite expensive. There was absolutely no discount for me paying out of pocket; they charged me the same as they would charge an insurance company. I therefore went online and did massive research and came up with a few suppliers who are one-third to one-half the price of the big companies, i.e. MedicalMega, STL Medical Supply, ExpressMedical are a few. From the biggies, a box of 20 Eakins cost me $203.00, from MedicalMega the same exact box, sealed, never opened, not seconds, cost me $89.00. Even with the $6.00 shipping that they charge for the entire order, that is a tremendous savings. However, they do not bill the insurance company. But for someone paying totally out of pocket, these companies are a tremendous savings, and they run sales and occasionally will give a "coupon type" of discount. They also offer free shipping on orders over a specific amount. MedicalMega is $400.00, and you get free shipping. However, the other two (and I cannot remember which amount goes to which company) are orders over $49.00 ship free and over $99.00 ship free. I am just recently insured, so I have not gone through the insurance company yet, so I am not sure how they are going to handle it. I will find out soon though.

I don't know if I can help, but if you have your doctor write the prescription for your ostomy supplies as "medically necessary", then that designation should place your ostomy supplies in a different category in the "health insurance industry" and change the status for payment for you. Not sure where you live, but health insurance rules and regulations change throughout different regions of the United States. It might be practical for you to go across state lines and see a doctor in a different state - I am not sure. Good luck. Either way, let your doctor know what your insurance company is doing - sometimes they can write (their script) around the particular health insurance problem when prescribing for you.

Thanks everyone for all your suggestions! Sounds like I have a lot of research to do. I cannot believe what these suppliers charge for our ostomy supplies with no insurance or sucky insurance like I have. I will say that when I checked with Liberator Medical they were about half the price of what my previous supplier, Midwest Medical, charged. I hope that my employer will hear my concerns with our current health insurance plan and revisit this issue.
Yance, I hope Obamacare comes through, but I have my doubts.

I was wondering how our government is regulating the medical supplies?
Lilly here in Indiana sets their prices for RX. They say that it costs a lot to develop new meds.
Well if they didn't pay high dollar for their help, and their benefits it would cut their cost. And no president or vice president of a company is worth over a million dollars a year salary!

Hello! I was wondering, does this man Scott Amiot work for Hollister or Convetec?
Thanks, have a nice day.

Rob

These companies spike prices because they know we need them!!