I am frustrated now

Wrote and called Medicaid of South DAkota, and yes, it is true, type II’s who are controlled, meaning you have an A!C below 7.0 are allowed 1 ----- ONE test strip a day paid for by Medicaid.

So here’s the history, I am a type II, controlled by Janumet 50/500 and amaryl 100. I swim four times a week and have a carb limit of 100 or less a day. My FBS have been higher, because of pain, and stress, but nothing over 140. BUT yesterday, I had to get not one but two cortisone injections and today my FBS is 510…YIKES! I knew that was going to happen so called all concerned and asked what to do. BUT I can’t get test strips to retest to day, because then I will be short at the end of the month. I also have to take 2 janumet until the numbers come down …but without the doc rewriting the script, I will be short on those and won’t be able to get them filled until Dec. 1

This sucks! We are told to test three to four times a day, yet we can’t get the medical help either doc, pharmacist or financial help to help us keep ourselves healthy. I know there are people who pay for their own strips, but I can’t afford them. Last week, I had a low, used four strips on that one, couldn’t test all week. This AM I didn’t have enough sample, used two strips for this huge number, and will continue to monitor it for the next three days testing more often till the numbers come down. How is that going to work at the eom? Guess I don’t test. And that’s NOT my choice. I like to know numbers, even if they are bad!

This sucks

My insurance won’t pay for more than two a day. I test four or five times a day.

I have had some luck buying test strips over the internet, for less than half the off the shelf uninsured price. Not quite as inexpensive as with medicaid or with insurance, but a great savings nonetheless.

If your doctor’s office is the one that told you to take 2 Janumet, then they need to change your script to cover that. You should not be expected to go without when you are already battling highs. I would call them back and make sure they get another script called in - even if it is just for a week, they need to call extra pills in. That is insane to tell you to take more and not change your script!

I agree with you on the strips. I had a feeling they were following Medicare guidelines because that is all Medicare will allow. I know you were thinking about going on insulin before. Regardless of what type you, if you are taking insulin, you need more strips. Medicare’s allowance is 3 per day but doctors can over-ride that. It looks like your state follows Medicare’s guidelines.

Not all states are proactive about health care. See if your state may have agencies or non profits that will help with your prescriptions and accessories.

I have found that insurance agents have a wealth of knowlege about how to get thing or at lease can direct you in the right place.

If you need help with a box of strips…write me or friend me on this system, exchange info and I will happily send you a box.

I always have to ask how Medicaid assumes people are getting A1cs below 7. Do they really think that the people with A1cs that low are testing 1x a day? And that the people who are higher need more strips cause they test more for that higher number? It makes no sense to me at all, and it’s really unfortunate that someone who wants to test more for better control is told no!

In the end this speaks to the profound misunderstanding of what diabetes is and what are the best ways to deal with it.

One thing for sure, going around for days at a time not knowing what your blood sugar is doing, is not the best way to maintain an excellent A1C and thus keep complications and high costs at bay.

I wish I could shake some sense into whoever is making these rules and fix this for you Cathy.

This kind of policy is the results of 2 things: 1) Evidence Based Medicine, which is relying on a study in Britain that said that monitoring didn’t make any difference in the A1cs of Type 2’s, totally ignoring the fact that if Type 2’s are not taught what to DO with their numbers, and are led to believe that they just record numbers for the doctor, of course it’s not going to make any difference. And 2) MONEY!! Type 1’s are a small part of the diabetic population, and everyone wants to take care of children (who, guess what! turn into adults with Type 1), but to cover adequate strips for adults with Type 2? Too expensive!! Especially when (note: sarcasm) they caused it themselves and could reverse it if they’d just get off their fat butts and stop eating Twinkies!

While I am, in general, in favor of single-payer health care in the US, it DOES carry the risk of coverage decisions being made from flawed studies, substituting statistics for individual needs, and letting financial considerations overrule effective care considerations. But then, good medical care has ALWAYS been for the benefit of the HAVES, and NOT the have-nots!

HI Cathy,

Sorry about your dilemma. My first question is will your Dr write a prescription for additional test strips? I had mine write above the minimum strips for me. Most insurance companies will not overide the Dr. I would assume Medicaid would be the same.

The other thing I wonder is why they would have not done a med adjustment allowing you insulin while you are on these shots? With this medication you are entitled to normal blood sugars. Even with the additional testing you still need to be able to control your BG. Without a med adjustment I dont see how thats possible.

I would pursue with the Dr and see if he/she will write the prescription for additional strips.