I had to start with a new mail order pharmacy company this year and man they question everything I submit before they put the order through.
My first order was for Ambien, Effexor, and my Ace Inhibitor med. They called me to see if I wanted the order filled now or to wait, WTF. Needless to say I had to borrow a few ambien from my sister while I waited for them to fill the order.
Today they called to check on my new order I sent in for Humalog and teststrips. My endo has gone computerized so the RX is all typed out and easy to read and it clearly stated 10-12 freestye strips per day, so once again I get a lovely computerized phone call, where I then had to wait for a real person who connected me to a pharmacist (ha) asking if it was the freestyle strip I wanted and then stated if I used one strip a day, I started laughing and she said well how many do you use, grrrr, I should of said can you read, but I just stated minimally 10 strips, ahhh okay just checking. I then politely asked even though I wanted to smack her through the phone are you going to fill both my requests of the insulin as well, oooo yes she stated.
The amount of work I go through for all this diabetic insurance, crap is amazing, plus I will have to pay a huge copay.
Not sure if it is the diabetes or just insurance companies in general, but it should not be this hard.
Then the same company will ask for me to fax them a copy of this same bill when it goes through my flex spending card, ahhhh the insanity.
I hear you. About 10 years ago I had crappy insurance from a previous employer, and they actually restricted the amount of insulin I was “allowed” under their plan. Took an angry letter from my doctor to get them to reconsider!
I’m so accustomed to insurance companies being stupid that I 1) Refused a prescription for an insulin PEN and instead insisted on scripts for vials and needles when I had gestational diabetes in 2003, and 2) Called THIS time - now Type II and pregnant, but with different insurance - to make sure the pens would be covered for exactly the same amount of insulin as the vials would be. I was stunned - they’re the same coverage. But I will always, always be cautious like that…
Meanwhile a diabetic co-worker said that on our previous insurance, diabetic supplies were NO CHARGE - huh ??? I definitely remember paying for my supplies on that old insurance… I guess something changed after 2003…??? Ugh.
I’ve been hearing rumblings that certain US states now have laws that require medical insurance to cover diabetes supplies and/or medications at no cost to the patient, to the degree necessary for the patient to meet or exceed the goals stated in the medical industry’s Standards of Care for diabetes.
If your state does not have this legislation, then your level of diabetes-supplies coverage is probably determined by a combination of what overall level of coverage your company has contracted for, the degree to which the insurer views the costs of diabetes self-management against overall diabetes-related medical costs, and the relative costs to the insurer of diabetes-related medical costs to all other medical costs.
Is there a way to find out which states do that?
I’m in South Carolina and betting that has happened here. I got dumped from 6 teststrips a day to 4 without so much as the Dr telling me that it had been changed!
I buy extra strips so I can test when I want to. :pppp the to insurance and dr! AS long as my hubby loves me and provides:) I’m “covered.” I got a great guy:) and wonderful Daddy to my kids. I’m spoiled rotten even though it is hard to pay all the bills sometimes.
I’ve done the same (paid for my own strips for that which is not covered by my insurance), though I’ve recently found out that my insurance is covering all my supplies and would cover meds as well, were I to need them… and I’ve been told that it is a state regulation in New Jersey. <shrug>
My Other Half suggests that you go to the South Carolina state government website and look for the office of the Insurance Commissioner, or its equivalent in your state. In NJ, it’s under the office of the Attorney General.
Check also with your Doctor: sometimes the doctor forgets and mis-writes a prescription. My Other Half is on 750mg Relafen BID for arthritis, and about a year ago the doc accidentally wrote it for 500mg instead… he had to go back to the doc to get an updated script because the lower dose was not working.
I’m spoiled rotten even though it is hard to pay all the bills sometimes.