Ostomy Supply Denial Experience

This survey has been put together by United Spinal Association’s Access and Care Coalition, which consists of urological and ostomy medical technology suppliers and manufacturers, as well as clinician, physician, and consumer and disability advocates.

Our mission is to advocate for policies and programs that ensure consumer access to medical supplies under Medicare, Medicaid and private insurance.

If you have Medicare or Medicaid for health insurance and have been denied ostomy supplies above the maximum allowable quantity limit (i.e., over allowable limit = more supplies than what your insurance typically covers) despite medical necessity being provided, please participate in this survey.

By sharing your insurance denial story, you are helping us provide the evidence we need to ensure you have the ostomy supplies you need and we will be sharing deidentified data with policymakers to help fix this problem. Together, we will improve essential coverage for ostomy supplies.

Thank you for your support.

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* 1. Age

18-24

25-34

35-44

45-54

55-64

65+

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* 2. Race

American Indian or Alaska Native

Asian or Asian American

Black or African American

Hispanic or Latino

Native Hawaiian or other Pacific Islander

White

Other (please specify)

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* 3. What state do you reside in?

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* 4. Type of Ostomy

Colostomy

Ileostomy

Urostomy

Don't Know

Other (please specify)

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* 5. Underlying Reason for Needing Ostomy Surgery

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* 6. Insurance Type

Original Medicare

Medicaid

Medicare and Medicaid

Medicare Advantage (Medicare health plan offered by a private company that contracts with Medicare)

Managed Medicaid (Medicaid health plan offered by a private company that contracts with the state)

Other (please specify)

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* 7. Where do you order your supplies from?

Local supplier close to where you live

National supplier

Other (please specify)

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* 8. Do you require more supplies than your insurance guidelines allow (ex: your insurance allows 10/month but you require 15)?

Yes

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* 9. What products do you need greater quantities than allowed (i.e., more supplies than what your insurance typically covers)?

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* 10. How many additional items do you need over the allowable limit (over allowable limit = more supplies than what your insurance typically covers)?

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* 11. Medical reason for needing more

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* 12. What was the reason for your supplies being denied?

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* 13. Did your supplier file an appeal, fighting the denial, on your behalf?

Yes

Don't know

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* 14. Have you ever won an appeal to get the quantity of supplies you need over the maximum allowed?

Yes

Don't know

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* 15. Dates/Length of Time for Resolution, if any

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* 16. Have you worked with a Wound Ostomy Continence nurse or with the manufacturer of your supplies to try alternative items that might result in longer wear time and less leakage, eliminating the need for an overage?

Yes

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* 17. Are you willing to share copies of your claims, explanation of benefits, and appeals?

Yes

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* 18. Contact Information

Name

Email Address

Phone Number