Hello! I’m hoping to tap into the vast experience on this site. I just got a letter from my insurance company (BCBS) advising me that in a few months, their policy for covered test strips will change from 300/month to 200/month regardless of amount prescribed. I am quite irritated because I already pay a co-pay plus out of pocket expense when I go over 300/month (which I generally do). 200 will obviously be more expensive.
What I’m wondering is the following: has anyone encountered a reduction in coverage like this? What, if anything, did you do about it? Were you successful? I’m more than happy to call and fight this but don’t want to start something if it will be fruitless. Any suggestions or experience with this kind of issue would be greatly appreciated.
I just got the same %$!#^! letter! I called them and was all ready to go jack golf balls through their windows from Millenium Park (HCSC=BCBS of IL/TX/NM/OK).
I talked to a few different people. Fortunately, I have one big kahuna refill still pending. They explained that the doctor has to (waste their valuable time) to write a “letter of medical necessity” because they think that I am a thief and stealing test strips from them? Freaking morons. So the doctor will write it, or her staff will print it off and stamp it with her signature and send it in and they will give me the test strips or their will be senseless acts of golf.
I’ve been told the same thing re stealing test strips. A pharmacist implied that I must be selling them on ebay b/c I refill them on the earliest date I can. Words can’t even describe my reaction haha! Thank you for your response; I have an endo appt this week, so I will mention it. Supposedly this won’t go into effect until April, at least in my case. Also BCBS of IL.
“Look at these fingers you bleep bleeper! Does it look like I’m bleep bleeping stealing the bleep bleepers?!!” (getting warmed up for my next call to them…)
I go through 300 or more a month and have experienced the same problem for the past few years with insurance. Now my new insurance doesn’t even cover diabetes supplies so we are having to purchase them. Walmart has a tester called Reli-On and 50 strips is 20 bucks. It’s quick and accurate. Good luck.
I want to whip my finger tips out too and say…“duh” …
I just got that same letter yesterday. My prescribed amount is 7x a day, which is 210-217 a month, so I’m just barely out of range. I thought I was on the high side of things, I couldn’t imagine another 100 on top of what I was using.
I do find it funny they cover my CGM sensors @ $42 a piece, which are good for 3 days ($420/month), but are going to short people of their coverage on test strips.
I am a fighter, and I had to start the fight with a doc who knew nothing about testing, she thought once a day was more than enough for me. So she prescribed 30 strips and let my ins company know that. I hate fighting with anyone, but this was one I was up for. I went to her and said, 30 was not near enough, 60 wouldn’t do it either…I went after the 300. If you make a mistake in judgement on the amount of blood on the strip, if there is an error, you’re done. I won that one. Then to fight the ins company because they went by her original orders. But I fought the enemy that I pay for, and yes won. I sent them information on diabetes, on testing, on the need for testing, basically flooded them with calls and information…until I got my 300 paid for. What you are dealing with is people who KNOW NOTHING about diabetes, unless they have it themselves.
So we have to educate, and that’s what I did. It took time, patience, and perseverance, but it can be done.
The FDA really says you need 200/month? Lame. Granted, I am a little OCD about my numbers and test a lot BUT being OCD has paid for itself by better A1cs. Seems like a clear benefit to let us have more strips - maybe up to 500 month, just to be crazy and make my point - as opposed to waiting for us to need expensive medical payments due to complications. UGH.
Not to take this too far on a tangent, but when do you need to test to get that much? Before and (2 hours) after every meal = 6, plus one before bedtime =7. That gives you about 200/month. Do you do middle-of-the-night testing also?
No denying I am a little OCD about testing. I test when I wake up, about 30 minutes after to verify that my morning bolus is working and I don’t need more (I tend to go high in the morning), I get ready and test again an hour-ish later for breakfast, then lunch, after lunch, late afternoon, before dinner (which is usually late - 8/9pm), after dinner, before bed (also late) and if my CGM wakes me up in the middle of the night to say I’m high or low, I test again to make sure. Then my CGM separately asks me to do 2 tests/day for it to verify the readings, which sometimes overlap with my usual tests and sometimes don’t. So I’m already at 9/day even if my CGM didn’t make me test at all. If I feel low or my CGM says I’m low or high, I test at those times too. My fingers are basically pin cushions haha.
Testing if you feel low, If you have been physically active, testing before driving, testing when you wake up, testing if you feel high. It adds up. I test when I feel I need to I work in a physical environment and my sugar can drop from 130 to 50 in a hour. I have adjusted my basal and it doesn’t help. I can snack at work but then I have to test to make sure my liquid intake and physical level are then keeping me from going high. I can get buy on ten a day 6-8 on off days but there are days I get 10 plus if I am feeling off.
Question for you Esjay- did the letter say all covered test strips or was it a specific brand? I’m just wondering if this is a case of the insurance Co could get a better deal from a different company and therefore are “preferring” a different brand or if it is ALL brands.
They actually did both. They bumped Abbot test strips from preferred to non-preferred and also limited all test strips generally to 200/month. Fun times.
Yea I got a letter like that last year and had to switch from the OneTouch Ultra to the Bayer Contour and I hated it. (I have been with OneTouch since Dx.) Luckily now I’m on the OneTouch Ping pump, so I get them regardless, but at the time my endo said the only way I’d be able to switch back to OneTouch and plea to have my insurance cover it was if I had a real reason (like being on the pump, which I wasn’t at the time.)
Going off people wondering about how some use so many test strips – I’ve never actually thought about how many I use a month, but considering I’m VERY active in collegiate swimming and dance, I can tell you there are some days I use WAY more than the normal amount… everyone is different and it depends on what your lifestyle is like.
Re the how do you figure you use so many question of MPetrick:
wake up check CGM, if it’s ok, I’ll bolus .2 or .3U depending on where it is, or do a CB if it’s higher than I want and add the .2.3, occasionally, I will test here? (1)
go down, bolus for breakfast (2)
get to work (note, blowing off of test before I drive, oh well…short trip…) about 7 and test again somehwere in 8-9 (pump will want it around 8 if I eat around 6 however I will sort of do PRN…) (3)
test around 10:00, again this can be optional but let’s say it’s Monday and I had two good workouts so we’ll test at 10:30 (4).
lunchtime (5)
If I’m ok, I’ll sort of surf the CGM through the afternoon and test again at 3:30 or 4:00 before I leave. Again, if my CGM is up, I’ll blow it off and go home, at great risk to fellow motorists and myself. Usually though I’m sort of anticipating a workout so I’ll test there to see where I’m at and see how closely the CGM is calibrated. (6)
Get home, nag kid about homework, dog, whatever, test and get ready to workout. (7). If the test is ok, I’ll work out and test afterwards, or maybe 20 minutes afterwards b/c I want to keep an eye on the spike and the CGM sometimes seems to get hung up low when I work out and doesn’t register the spike until it’s too late. In the winter, I don’t take my meter with me because the freeze and are pretty much useless. I signed up for a marathon, perhaps ironically the day before I got the 'congratulations, you get 200 strips/ month instead of 450!" letter so I am going to be doing more longer runs as the day gets closer.
cook dinner, test again before I eat it (9), maybe 7:00?
test again 9:00 (10)
test again 11:00-12:00 bedtime. (11). That’s a pretty conservative day. If any number is off a bit, blooey, there’s another potential test. If I drove farther/ was responsable, there’s 2 more tests. I don’t think that’s unreasonable, I’m blowing off several potential tests. I think too that it’s useful to test your BG twice in the morning to check for DP but, since we got the dog, it will go bonkers if I go down to do that without her so I blow it off too.
Also, if you’re trying to figure out correction ratios or insulin-carb ratios or doing basal testing, you could be testing every hour. I am Type 1, using MDI and my prescription is for 8-10 times a day, and sometimes that’s no where near enough.
