So this may be a long one
On Feb. 16 I called in my presciption for my insulin and test strips, that I could pick up the next day. Went to the pharmacy on the 17th to find out that I needed a prior authorization for my test strips. Thinking that I had enough strips left to last me a couple weeks, I left them to go about the process of getting a prior from my doctor. I called the pharmacy the next week and they tell me they haven't recieved anything. So I called the nurse at my doctors and she tells me they have sent 3 prior authorization forms to my insurance and they have all been denied. Then later I recieve a letter from insurace saying....
****** REQUESTED SERVICE: FREESTYLE TEST STRIPS 300 A MONTH******
" We have recieved a request for benefits for the service identified above. This service and/or coverage has not been approved for the following reason(s):
-The benefit provides coverage for the requested drug when medically necessary. The information submitted does not meet Humana medical necessity guidlines for coverage. The member must meet the following critiria: previous trial of accu-check and life scan's one touch test strips."
What is not medically necessary about me needing these test strips? I need them they work with my pump.
So then my dad calls insurance serveral times and gives them a piece of his mind, they tell him what should be done and then I would be approved. Wrong still denied. My doctor then sends in an appeal....DENIED then my doctor does a peer to peer with the doctor at Humana. DENIED.... Now almost 2 months later I get a form from insurace saying that I just need to sign it and fax it back to get approved. We will see how that goes, I just got that form today.
Here is my question????
Me and my younger brother both types 1 Diabetics are on the same insurance, have been for as long as I can remember. He uses the same pump and test strips and doesn't have a problem getting them, but why do I ?????
My a1c prior to all of this going on was 5.9 I am 100% positive it will be higher when I get it checked in May, because I currently can only test my sugars less than 5 times a day because I have a limited supply of freestyle lite strips that my doctor gave me. They dont work with my pump, it takes plain ol' freestyle. My blood sugars have been off the charts and the stress of all this insurance crap is taking me down. I have used these test strips since I started my pump in September 08 and never had a problem before getting them. Stupid 2010 had to show its nasty face and insurance had to be incompetent morons.
I find out also I could just use a different glucose meter, but who out there using a pump would WANT to use another meter when you have one attached to your pump, it so much less complicated...