Full timing and health insurance coverage

[In_Pursuit_of_A]

I am an RV'er myself (with a Class A), but my husband and I are still working full time. However, today I am in the Full-Timing Forum to ask for feedback on how full timers handle travel and medical appointments. I realize this is an unusual post, but let me explain. I work for a major health insurance provider and we have a situation with a member who full times and has Medicare as his primary insurance, with our insurance as secondary. This member requires an insulin pump, but Medicare is now refusing to pay for it because the member is not able to attend a regular medical appointment every three months. The member is on the road and cannot always get back to his primary care doctor every three months.

I don't want anyone to share their protected health information -- I am just looking for general feedback from anyone who might have experienced similar challenges with Medicare and required medical appointments -- do you use urgent care facilities, do you stop at hospital clinics? Also, this is an individual who consistently moves around, as opposed to a snow bird who goes south for the winter/north for the summer situation.

Thank you for any information or tips you can share. Our company would like to assist this member, but we are not sure what to suggest.

[cnehodgdon]

I would suggest that you have this conversation with his doctor, as well. The doctor may have some ideas that could be helpful. Obviously everyone's situation is a bit different but perhaps you can with some planning figure out a way to do this with the doctor at home.
I remember meeting a couple that have a primary physician back home as well as in Florida.
Good luck!

[In_Pursuit_of_A]

Thanks so much for your feedback everyone. Unfortunately, I think you are right - he is either going to have to pay for the pump or go back to shots if he cannot meet the Medicare guideline for an appointment with his physician every three months.

Again, I appreciate everyone who took the time to respond!

[Cobra21]

He may have to go back to old fashion injections or pay for the pump. I know they
like to monitor the pump and pump use, but traveling makes that impossible.

I as a diabetic wish him well.

[sdianel_-acct_c]

We have our doctor provide us with prescriptions and orders for blood work that is necessary to comply with prescriptions and Medicare. We don't use an insulin pump but this has worked for other things. I think the rule is that you must see a provider that cares for other people on insulin pumps, not necessarily the doctor you always see. I have used Medicare all over the country and never had a problem. I think Medicare and the primary physician could figure this out. Thank you for helping. I've been there with my Mom and it's overwhelming!