Remember how excited I was about this new bill?
The insurance company responded by making the Doc write scripts for 3 boxes of insulin pump pods at a time. Checkmate.
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I see the dots but I’m not making the connection to checkmate. What am I missing?
1 box is 5 pods so 3 boxes, depending on the script, is 30 to 45 days supply. Assuming 30 days the script should have 12 (or 11?) refills making it good for a year.
Is the problem you were hoping for a 90 day supply? That’d be $150, still not bad considering everything else is free
Insurance doesn’t talk to the doc. insurance talks to the pharmacy who talks to the doc on your behalf. So whatever happened most of it can be found out in the pharmacy. If there was a claim denial a call to insurance for the reason may be necessary.
They cut the amount of supplies available via any give refill in half.
Yes, it used to be a 3-month supply, but now its a 6 week supply.
Part of what their doing is increasing the administrative burden.
It’s not just pods, right? Now, I only get a months worth of BS strips at a time. All the fill dates are asynchronous. Because the copay cap is per purchase, they are gonna make it as difficult as possible to refill more than one script at a time. They are being pains in the asses.
What i find particularly annoying about this is that they are executing control over the doctors. There is absolutely no medical reason why our script supply should suddenly be cut in half. It’s the insurers directly influencing the practice of medicine. They pretend like its not them, like its the doctor. But its not the doc. They are using the doc as a meat shield to hide behind. The docs are a bunch of cowards, so it works flawlessly.
Yes, and they’re smoking in the alley behind pharmacy when they do it. Sadly you have to harass the pharmacy to get you what your plan covers because your plan gave bad info to the pharmacy. Note they can’t go back and fix it once you pickup the script so this is planning for the future
The copay cap is per month. But in the name of sanity get your pickups bundled together. Refill date is based on Fill date, not the pickup date. So if something is ready to be picked up like test strips let them sit a week or two till you’re there for everything else. Or, once they are done un-bleeping your pod script, tell them to do partial fills of everything else so you can pickup everything at once with your pods. Once everything is time aligned stick to it. I did it with my mail order meds lots of years ago and just had to do it again recently after a doc wrote a script wrong.
I could hear your voice telling me this in my head when I picked it up.
They rewrote the script. I went ape ■■■■ on them and demanded a medical justification for cutting the supplies in half. The doc fixed it.