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41,423 members
Mar 25, 2014

New at This Ostomy Stuff

This topic is about a person in the U.S. who recently had an ileostomy and is facing challenges with their health insurance. The insurance company is labeling the ostomy as a "pre-existing" condition, which means they are refusing to cover the cost of essential supplies like wafers, flanges, and bags. The person is running out of hospital samples and is considering homemade solutions if necessary. Here are some helpful insights and advice for dealing with this situation:

1. Avoid homemade solutions:
- Experienced ostomates advise against making your own flanges and pouches. These can leak, irritate the skin, and cause infections. It's better to focus on getting the necessary paperwork from doctors and insurers.

2. Challenge the insurance classification:
- Argue that the ostomy is new and not pre-existing. Get your surgeon and general practitioner to provide documentation quickly to support your case.

3. Gather supplies from fellow ostomates:
- Some community members are willing to send extra supplies like Hollister two-piece systems, Econ seals, and ConvaTec pouches. They have shared contact information for coordination.

4. Request samples from manufacturers:
- Call customer service at companies like ConvaTec, Hollister, and Coloplast. Explain your situation and ask for free samples of bags, barriers, rings, and paste that fit your stoma size. Some people have received significant supplies just by asking.

5. Look into charitable and public assistance:
- Depending on where you live, there might be programs to help. In Canada, for example, some provinces offer grants or coverage. In the U.S., some states or non-profits provide support, but it can be tricky if you already have insurance. Persistence with insurers and healthcare providers is crucial.

6. Understand supplier payment requirements:
- U.S. distributors like Edgepark may not send new supplies until deductibles or co-pays are met. Use samples and donations to get through these periods.
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