Is there anyone else experiencing difficulty with getting supplies with the change in insurance coverage?
I recently switched to Blue Shield Calif Care. My insurance started up on the 1st of April. And it has been that long trying to get prior authorization for my test strips, MIO infusion sets and CGM. I test 8-10 times a day. 5 meals and before/during/after exercise. And any other tests for calibration, low BG's, high BG's, etc. The insurance only covers 200 strips. But I have been waiting on this authorization for nearly a month. And Blue Shield is not contracted with Medtronic. Medtronic says B.S. is contracted with another distributor that supplies Medtronic equipment.
Has/is anyone else dealing with this problem?
What are you going to run out of, BEFORE this nightmare gets straightened out???
Lancets, reuse em… until you have to change one.
Got any unused syringes left over somewhere? One syringe can be made to last a very long time.
Strips, the generic ones at Walmart, Target, etc should keep you testing if you need more tests in the interim without costing you an arm.
Frankly LESS testing is probably wise until you do get this straightened out… and you will, but until then, fewer tests will likely be required.
They did not exist until fairly recently… you will survive, simply treat ultra conservatively with any bolus. Millions of us did just fine before the testing and technology obsession… You will be ok too ; )
Wow!! those were reassuring words.
Lets see, lancets are cheap - I have to pay out of pocket anyway - I change them out daily with no exceptions cause they start to hurt.
I didn't know there were generic strips. Do they work with an Accuchek Nano or do I need a new meter to use them?
Less testing would be 8 times a day. No exceptions. I test before 5 small meals and before,during and after exercise. I guess I could give up exercise and watch my BGs go up. Maybe guess on a few meals and go by the amount of carbs and do no corrections.
I think you missed my point. My question was directed to those who have switched to another insurance with a preexisting condition and have been held to wait a month to have their prior authorization to be completed. That is what I was referring to.
And for the record, I do have the money to support my diabetes routine for a month or two. But waiting on my prescriptions to be approved, purchasing my own and not knowing if I will be reimbursed makes me a bit upset. My frustration is directed to the slow processing of the insurance company. Don't mean to sound ungrateful but sitting on the phone waiting for 4 hours with no response is poor service to me. My doctor's office is also having trouble getting through.
But judging by the response, I may just be the only one. But I doubt it.
I have Blue Cross Blue shield (not sure if it's the same thing) and they refuse to provide more than 201 test strips/month and no more than 1 month at a time. I gave up fighting them over it and now purchase the rest out of pocket. My doctor was furious. It's worth it to me. I tend to purchase 100 boxes at a time, since they are the most cost effective. I also now beg my doctor for samples. That helps.
You can buy the walmart relion meters for $16-20 and the test strips are 50 for $9. The lancets are pretty cheap too, they have ultra fine ones now too which are pretty good.
I agree that less testing shouldn't be necessary. I think that testing should be a civil right instead of a bean to count.
I have BCBS, although through HCSC rather than through California. I was always very hesitant to use their prescription vendor but, when I gave in, it actually became much less work to get the strips I need, insulin, etc.
They still send a yearly which used to be "you only need 4x strips/ day" but the one I just got said "you only need 6 strips/ day" which I guess is progress of sorts but my 14x/ day rx still gets filled. The doc has to waste their valuable time writing a stupid letter to tell them they are full of crap the strips are "medically necessary". It's good to get the refill on the yearly "we need a new letter of medical necessity" garbage called in with plenty of time but, other than that, the BCBS mail order (Prime Mail I think? I always call them Primax...) seems to work very well.
Unfortunately, switching insurance bangs us up against having to re-establish all our negotiated coverage. Most insurance companies take a stingy attitude and make you rejustify your testing and such. This will often require your doctor to write a letter of medical necessity. And when you change insurance, all that has to be redone. Sometimes even if you don't change insurance you will be forced to go through this yearly like acidrock.
And many companies have taken a cue from medicare and started to reduce their approved suppliers restricting access to many products. In the end, there will be a way to get your Medtronic supplies, but they won't just give up that information. A good way of forcing that is to make Medtronic work for you. You can tell them you are having difficulty getting Medtronic supplies covered by BCBS and that you may have to switch to another pump if it cannot be resolved.
ps. Prior authorization is not something that takes a month, it should be done within a day. If you are denied, then you can appeal, file letters of medical necessity, etc. That can take longer, but prior authorization should be done quickly.
How ironic that we have to have a letter of medical necessity every year. As if we are now not in need of test strips. We are cured!!!! Yeah right.
As far as a civil right, I personally feel its a consumer right that is being violated. And how dare they decide what me and my doctor feel I need to manage my diabetes.
Thanks for the reply.
How's the accuracy compared to other test strips of the non generic brand?
I agree with Brian, the supplier or manufacturer can be a great advocate. My insurance is with Blue Cross/ Blue Shield of Louisiana and my CGM transmitter warranty expired recently and the transmitter died. My supplier, PumpsIt, was great in advocating for me with BCBS. Apparently my insurance caseworker thought that my CGM is an insulin pump and would not approve it because I am already on a pump... this has happened to me twice in the last few years. The PumpsIt rep talked to the caseworker and got approval over the phone in the same day. I had been trying to find out what the problem was for two weeks and it was resolved over the phone the same day... so frustrating.
My insurance requires recertification every 6 months for some of my supplies and every year for others. I don't get that either since my diabetes is not going away... the only thing I can think of is that it's a way to force the doctors to send them clinical notes on the patient, but I don't really understand the need for that either with diabetes.
Who's your supplier for 100 boxes? Is that 50 ct? What is your cost?
Sorry to sound like I'm grilling you but I have priced some 50 ct boxes during this long wait. The cheapest pharmacy was Walmart - $72. And a diabetes supply website - diabetes promotions was $41. It's expiration date was 6 mo out. Apparently these were leftover from Medicare/Medical.
Anyway, just curious and it sounds brilliant.
Thanks for the input and advice. Hopefully I won't have to resort to strong arm tactics.