Just got back from the pharmacy where I was informed that my endo had prescribed 300 strips for the month for my daughter (10 per day) but that my insurance would only pay for 200 (6 - 7 per day). Truly, the lesser amount should be plenty for her, but it made me wonder if others have run into this restriction. If she does need more strips, has anyone had luck persuading their insurance to increase the amount? Thanks.
Your Dr’s office will need to contact the insurance company and ask what the procedure is to get an overide to their limitation. We get 250 a month, and our Dr completes an over ride for us each year. I found out about this when years ago, we had some pretty lousy insurance, and they were trying to tell me I could get by on 100 per month, 3 tests per day, never mind calibrations or wasted strips for a 3 year old, imagine that!
My endo dealt with the insurance issues (as well as my mail order medical supply company) to over ride their maximum per day which is 4. I am currently allowed 10 per day.
I have a friend who has a maximum of 2 strips per day on her insurance. How in the heck are you supposed be able to control your diabetes with only 2 testings per day? I see her trying to treat a “low” or a “high” without testing to make sure the symptoms she is feeling are actually caused by her glucose levels. I keep trying to tell this person that she needs to test more but the doctor has told her that her diabetes is not that bad and she does not need to test more than 2 times a day. I am so glad that I have the doctor that I do that will fight for anything that I want.
I went to the pharamacy last month someone at my Endo’s office called in the RX for my strips stating I tested 3 times a day. The pharmacy said my insurance will only pay for 3 times a day but they will call my doc to have them call to have the decision over turned. This has never happened to me before.
Call your daughters doc, they can have it changed.
Our Insurance phoned to ask if I actually used 300 a month. I said Yes(which is close(7-9) and they agreed with it.
You should be able to override this fairly easily… but it may take some action by your doctor. Ask your insurance if they need a pre-authorization or something else, so that you can get things started on that process.
Generally for a T1 they’ll let you get whatever you need, as long as a doctor states that it’s necessary. I get 300 which is plenty for me, but there are others who get as much as 500 or 600 a month.
Yes Ive had the same problem as well. The insurance company stated research says 4 times a day is enough. I asked them when they started practicing medicine or if they were diabetic. No response.
I had to ask my doctor to right a letter, in addition to the prescription, to get 200 a month.