Does anyone else ever get a call from their insurance company if they are late ordering a med and they think you are not taking it? My internist office called today saying my insurance (secondary since I am on Medicare) called them to say I was not taking my (specific med)! Well, I am taking it and was a bit late in sending a new script for more but I try to build up extra meds and had enough to last me. I had gone beyond my 90 day supply in reordering.
This has happened to me once before with a different med–same issue, last year.
I think it is strange. It had never happened with me before last year so I wonder if this is a new policy with insurance companies that they keep track of your med orders and “tell on you” to your MD. And I certainly have been late a few times over the years though it is only a very occasional thing. And, as noted, I build up a supply by ordering a bit early each time. I do not like to run out. My secondary is BCBS. It feels a little like Big Brother is monitoring my med intake.
Could it have anything to do with my being on a pump? Or just Big Brother.
I have never had that happen. I think I would be really ticked if that happened to me. I frequently skip stuff for a reason. I take a diuretic and when I go to doctor’s appointments, it is an all day trip to Pittsburgh for me and it is not possible to be running to the bathroom when you are in a car. I have stopped taking stuff when I suspected it had gluten in and would wait until the symptoms cleared up before taking it again to rule it out.
I also have a Medicare plan. Maybe it is possible that they call the doctor & the doctor just ignores the call. There is a new Medicare ruling that just went into effect having more coordination of care to have better outcomes - I haven’t had a chance to read that yet to see what is going to happen there. My first thought was that maybe that had something to do with it but you said it happened last year also.
I have Caremark. They do these types of things all the time. The more you order your meds the more likely it is they make a profit. Even though it seems like those with insurance pay very little compared to cash pay prices you can bet these pharmacy programs are making money every time you order so it is in their best interest to call your doc to get them to “yell” at you for not taking your meds.
I believe I would hit the roof before realizing they are just trying to look out for your health. After all a healthy you will cost them less in the long run. Even realizing that it would still rub me the wrong way. I’ve about had enough of the so called nanny state.
I also like Acidrock’s answer. That might teach them to mind their own business.
I got a call about 3 or 4 years ago when I was on Lipitor. Blue Shield of California (BSCA) called to make sure I was taking it and asked if I stopped. They told me if I stopped taking it, I needed to discuss it wiht my doc. That is the only one I have received of that type. A nurse from BSCA calls me every 3 months to check on me and my meds and see if I have any questions ro concerns.
Ya, AR’s answer is really cool. Like that, but I don’t think it will deture them.
Yes, I’ve had calls about reordering meds, even Target has called to ask if I wanted to refill a pers. Also an old doctor I left, keeps sending me literature of seminars he is holding, and he called Target to reinstate some meds for me after a year of not seeing him. This was surprising that he would call them in, and you’d think maybe he would realize I was not coming back.
Also, I’ve had BCBS call and ask how my BG’s are, my A1c’s, how much insulin I take etc. Funny thing is I am deaf but they refuse to talk to my husband, so he has to tell me what they are asking and I have to answer them. Oh by the way they did not agree on the A1c that my doctor said was good. Doctor was ok with 5.5 but BCBS said a 7 was better. I told them I go by the law of small numbers and explained what that was, they did not think this was healthy at all and told me to eat more and take more insulin.
My HMO has a robo dialer that actually called and said someone in our household was on a cholesterol med and were we taking it?
That was me. I am terrified of the side effects since I have fibromyalgia. I waited until just four weeks before my next appointment to start the pills. It apparently noticed. Or something.
Then, the pharmacy where I get my strips called and asked why I hadnt picked them up.
I have a bit of back log on them, and dont usually run out. But I decided, ok, if they are going to be checking up on me then I will fill them more often and keep them around. If that is what they want to do, fine, I will be happy to pick up my order monthly.
I think this is the greatest answer I read yet. My Pharmaist told me the Dr. doesn’t know if you fill your meds or not. I get free samples on insulin sometimes from my Dr. and so far Liberty hasn’t called to tell me that I’m not taking my required amt. When on a pump and your BG’s are normal, you sure don’t use as much insulin but then again if your BG’s are high and use more and run out, is your pharmacy going to ship you more if you call them? I’ll just go to my Dr. and get a vial to tide me over. I can believe anything the Gov. is involved in can sure get things screwed up and everything that involves money is the name of the game today. The heck with your health. Ain’t like the 50’s or 60’s. It’s all a crooked game out there. Fishinglady
The Dr.'s don’t even check the side effects with other meds you’re taking. I was prescribed one med for esophogus and was on Actonel for osteroperois and was reading the insert on Omeraprozale and it stated it promoted osteroperosis. I never took another one or got it refilled. So far neither Dr or Pharmacy or ins. has called. Just get that drug out there and make the billions, then check the reactions when the patient nearly dies. Look at Avandia and Actos. The Pharmacutical Co. is all for the money, not your health. How many new med samples do you get when you go to your Dr? Nexilant for GERD, Livalo for cholesterol. The Drs. dont read the inserts before handing you the samples. Pays to read the inserts first.
Actually, you would be surprised at the amount of presumably “private” health information is actually usurped. Drug reps can get listings of all the prescriptions a dr has made and use that in their marketing. Insurance companies monitor what prescriptions you buy and intervene in your medical care. During my personal “cholesterol wars,” I had to actually notify my insurance company that they were NOT licensed to make medical recommendations and to please stop sending out letters to everyone suggesting that I be put on statins. Statins were toxic to me and it was just stupid for them to undertake a campaign to eliminate me from the earth.
At times over the years, my insurnace has also assigned a “nurse” to “help” me with my care. After a while it became clear that the nurse was of no help, she was minimally competent, had no advice for me, would not intervene or advocate for my care with my doctors or even help get insurance approval for things. The point of the “help” was to collect information about me. So I no longer cooperate with the clandestine intelligence operation.
So yes, it is big brother and I consider it an inappropriate monitoring and intervention.
Yeah, I had the nurse thing too.
A caseworker nurse who swore she could get me a new pump (my copay is really high).
She didnt do anything, I had to send financials.
Thank God my new pump is supposedly on order, but I dont know if I have heard the last of her.
She insisted they only cover pumps when yours is broken (not true).
I think BC tries to get all their pts to talk to a nurse about managing their health. I have always refused. First, I was a nurse for too many years to count and I think that if your A1c is good, then you are probably managing OK.
But it does bother me that a stranger in an office a thousand miles away is looking at my list of meds and judging that I am not taking one of them.
I, too, like Chadd, try to keep a good stock though I don’t manage it for all meds. I also always take two extra weeks of meds when I go on a trip. Accidents or illness can happen. And now, with so many tornados and earthquakes and so on I think it is wise that everyone have at least an extra month supply of all their meds. I know it is hard to do but, as Chadd said, if you learn the earliest you can reorder, then over time you can build up the supply. I always use the oldest meds first, of course.
My own home town was wiped out in the April 17 tornado that went through the south. (I don’t live there.) That included that small town’s pharmacy, all other businesses and multiple homes. Imagine if your prescriptions were in that pharmacy and also imagine if your doctor’s office is destroyed. (there actually were a couple of docs in a clinic in this small town). That possibility alone is enough to make you put all those meds & other essentials in a bag and stash it by the door you use most!
I think that a lot of these calls result from studies that show how many patients are “non-compliant” in taking their medications. I know that “compliant” is a word that many of us on these boards abhor. However, you must remember that most of us who participate in online forums are “cream of the crop” patients. We are educated about our diabetes and other medical conditions. We may not always follow doctor’s instructions blindly, but if we refuse a medication, it is usually because we have done research and have valid reasons for not taking it. Not all of us have great insurance or lots of money, but most of us do our best to get the best tools to optimize our diabetes care.
Many patients in the “real world” don’t take their meds or test their blood sugar. There are lots of reasons for this. Some people can’t afford their medications. Some people don’t really understand the instructions they get at the clinic or doctor and don’t have a clue how to take care of themselves. Some people just don’t care. You could go on and on.
The idealistic interpretation of these insurance calls is that they are trying to help patients take care of their medical conditions. They want to catch patients who are not taking their Metformin before an amputation or blindness result from years of not taking meds. In the best of all worlds, these calls would result in financial help for people who can’t afford meds. They would result in education and support for people who don’t understand their medical condition and need help navigating our healthcare system.
Yes, for many of us, this is Big Brother checking up on us. I have always declined the diabetes care programs through my insurance, because I know more about Type 1 than all of the nurses trying to “help” me. These programs are all geared towards Type 2 and are incredibly basic for those of use who know a lot about Type 1. I personally don’t get motivated by a workbook trying to help me lose weight and take my pills on time. But maybe some people are and need the support of someone as they learn about diabetes.
Well, I can’t disagree about the many who don’t take their meds properly. Though much of it is due to lack of insurance and cost. I wonder if a study has looked at the groups of inadequate med taking for those who can’t afford it vs those who can afford it but choose not to take it.
I am guessing that cost is the big factor but that a small minority would say they don’t think they need it. Especially type 2s who initially feel fine and don’t “feel diabetic.” If we only had health care as standard care for all and not the privilege of those who can afford it (have good insurance) or the very poor. The lower middle class and the ‘nearly poor’ are left out. Sorry to get going on one of my "things."
Therefore, if the insurance companies find someone not taking their meds, the better question would be "is there anything we can do to help make it possible for you to take your meds?"
Thanks for the point, lathump.
I’m Type 2 and I stopped my meds because they raised my numbers which led to serious infections and neuropathy. Everything else available has the potential to cause cancer and I already have cancer. I wish there was something safe beyond Metformin to help me. (I already take a low dose). One has no control when taking meds. There is no basal…no bolus… just 5 min with the endo as he writes another script. One has great difficulty getting even one strip a day prescribed.
Sorry… I just wish everyone would understand that these meds can be worse than the insulin resistance. While most of the T2s I know are terrified, they need to act as if they are not worried. So often I read the posts on here and feel hopeless. Joanne
Can you believe this? I just logged in to medco to check my med status for my endo visit and I had a message that said:
Keep up the good work!
N___, you have met 5 health goals.
Our records indicate you are on track with:
[and they list 4 meds plus ‘monitoring your blood sugar’]
I did not know I had 5 goals, or any goals with them! Talk about Big Brother! We are all in the database and they now have programs to communicate with our data.
