r/Medicaid • u/Serious_Koala_8706 • 22h ago

Getting enteral feeding supplies covered

I have severe gastroparesis. I have a peg GJ tube. I use a kangaroo omni pump. They sent me the single bags. Is there a way to get Medicaid in PA (UPMC FOR YOU) to cover the double bag sets that do automatic flushes so I don't have to set alarms all night?

Tips and tricks appreciated!!!

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u/LadyGreyIcedTea 22h ago

My experience with these types of things is that is not that insurance "doesn't cover" the double bags but those bags are covered under the daily per diem rate, which is a flat rate for supplies regardless of what supplies are sent, and the company says "insurance doesn't pay for those bags" because it costs them more to supply those bags than the single ones.

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u/beepb0obeep 1h ago

This is it. Some dme companies will provide them and eat the cost, uou can always ask.