Roller Coaster with a Happy Ending (if only...)

I've been working on getting approval for a new insulin pump since July; mine has been out of warranty since the end of March. My employer self-insures and contracts with a management/administrative company. The administrators rejected my request, saying that as long as the pump was working they saw no need for replacement, but that my employer's HR department could overrule their decision. No clear appeal process was offered, so I muddled through multiple channels, appealing to both HR and the plan administrators, occasionally seeing a glimmer of hope before being rejected again.

Last week, our HR benefits manager wrote me an email that got my manager and director almost as worked up as me. Keep in mind, this is following a string of correspondence including the suggestion that I consider a glucose monitor rather than an Animas pump. It has been clear to me that the people making decisions about the tools I use for my self-care have no idea how those tools work. The note that pushed me over the edge:

"I am sorry this has taken so long. I wanted I made sure I understood everything. I applaud you for being concerned and fastidious about your own health. However, I am honoring [insurance administrator's] recommendation not to replace your pump at this time. Your pump is engineered to register a warning well in advance of its failure. Many items have up to 100 percent of their usefulness well beyond their warranty. For plans to replace items at their warranty may encourage suppliers of medical items to make shorter warranties.
"Please make sure you stop by your clinic and they can confirm that your pump is starting to fail. They can call [insurance administrator at phone number] at that point in time. It is then that the plan will pay per the plan rules for a new pump."

The patronizing tone coupled with claims of non-existent features of my pump and technology diagnostic capabilities of my doctor's office were too much.

This weekend, the screen cracked - I am happy to be very familiar with my pump's menus so I know what it says even though much of the text is obscured. With a cracked screen, failure was imminent so my doctor, pump company and I started again last night to reapply, noting that my current pump is malfunctioning. This morning, before any of the new paperwork was turned in, I got a call from the plan administrator that employer's HR dept. had overruled their decision and I was clear to get a new pump. Several phone calls later and an Animas Ping is on its way to me. The dynamic duo should be in my hands tomorrow morning.

I have no idea how this got sorted out. My manager had been trying to figure out who to talk to about the unprofessional way I was being treated, but had not yet taken it over the head of the rude, misinformed benefits manager. I was too angry to communicate with HR. I am still frustrated that I don't understand the policy or the appeal process, but I am trying to enjoy the relief of being granted a new pump.

I feel pretty wrung out. I know that the CGM integrated pump is due out early 2010. I'm tempted, but I have no interest in going through this again so soon. I'm leaning toward a service dog instead. I think I'll send my first fundraising letter to the benefits manager....

This afternoon, I ended up revealing to our CEO that I have T1. He was better informed than many, but seemed surprised and commented that it's a lot of work managing diabetes. I didn't have the energy to tell him that managing health insurance is even harder than managing bigD. But, I realized after the conversation that it was a fitting way to raise my voice during Invisible Illness Awareness Week. I'm still debating whether I want to make it visible full-time (which a service dog will do), but I think I'm getting more and more comfortable with the idea. Maybe it's ok for people to know my brain is working on a few more things than "normal" all the time.

Thanks for 4 years of hard work, Eric. You deserve a restful retirement.

While spending a last day with Eric, I'm working on names for my Ping system (a pump and meter pair). Feel free to offer suggestions; I might take one. One hint: while superheros and sidekicks pop to mind, they're not likely to win top prize.