I use the Bayer Contour Next link glucometer that was provided with my new Medtronic 530g pump in late 2013.My insurance company is Medical Mutual, who supplies through Edgepark. The prior written authorization I got in December 2013 ran out at the end of June 2014. I had enough strips through July 2014. On August 1, I called into my endo's office to request that they send in another a prior written auth. as they had done before, with success. After multiple attempts and phone calls, the PA at my endos' office said that the Edgepark reps told her that "She should try to use the one that is covered ,the Accu-check Aviva." I am floored. Edgepark says that Medical Mutual will not pay for the Bayer strips anymore.
I checked the formulary of the insurance company and my retirement system. Their website, BTW, makes it a tad tedious to determine exactly what meds/supplies are covered :you have to scroll through an alphabetical list of every meter that ever existed, and then click on it to see its description and if it is linked. But they tell you right up front if it is a covered device. They will cover other meters, but it appears that the Nova Max Plus may be the only Linked meter they cover. I have used it before and already own a glucose meter, but I frankly prefer the Bayer contour next link meter that came with the MM pump. It is easily downloadable , very compact, has a back light and works efficiently with the pump. I consider it a medical necessity , but evidently Medical Mutual, through the plan purchased by my former employers( I am retired from a school district and am covered by the state teacher's retirement system); does not consider it so.
My endo's office is going to appeal this decision. They gave me a few boxes ( total 40 count) of Contour Strips.. I wonder if I should not count on the appeal and just change to any linked meter( my second choice) and strips for whose strips that they will pay for? I am certainly not going back to a non-linked meter, if I can avoid it.. Haven't used any non linked meter in over a decade, except for a one-touch ultra mini for when I was traveling or engaging in sports and exercise. I liked its small size, which is one of the features I like about the Bayer Contour Next meter.
Suggestions? Appeal will commence..Anything I can do in the meantime, other than pay out of pocket for the strips I want? My endo's office can supply me with a few at a time, about 4 containers with just 10 strips each
I am down to rationing strips and using whatever I already have to make this through...I guess I will just have to pay until I know otherwise. I really like this meter and do not want to switch!!This definitely will have me testing less! UGHH!
I am very grateful to have insurance. Lord knows it was such a help to me during the ankle break, the surgeries, and the therapies:I just did not anticipate that getting the most effective, efficient treatment tools would hit a stumbling block.