Insurance question - user of One-Touch Ping

Type 1 and LADA
1

I had very good health insurance, and at the first of the year, my employer switched health insurance companies.

I received a letter from the insurance company saying that the ONLY glucose testing system they cover is WaveSense (or something like that -I've never heard of it).

My problem is that my 5 year old uses the One-Touch Ping. For those of you who don't know, the Ping glucometer uses one-touch strips and after collecting a BG value, it "pings" the information to the insulin pump wirelessly. You put in the carbs you are scheduled to eat, it tells you how much insulin to give, you confirm and BOOM, the little child is bolused without anyone noticing!!

Having a 5 year old with diabetes means she has several caregivers, because heaven forbid I have to go to work and someone else needs to watch her. So I need her treatment plan to be as EASY AS POSSIBLE. The one-touch ping has really been a blessing for the 2 other caregivers involved with her, and I can't add another variable into the equation. If we used the WaveSense glucometer, we'd have to take out the insulin pump, manually put in the BG (and probably input it incorrectly, just another step for error), etc etc....

I called the insurance company to ask if they could make an exception. I explained the situation, and they said they'd get back to me. Days later, with no reply, I called back. They have no record of me calling them. Of course the people on the phone do not even know what I'm talking about. They don't know about the letter. They don't know about diabetes. So I started from scratch explaining the situation again.

Do you think they will make an exception?

Of all the things diabetes, I could probably afford most of it out of pocket worst case scenario that I didn't have insurance. But the test strips are a killer. Cashes out to $10/day without insurance. Insulin, $100/mo. I could swing that if I didn't have insurance. We could go back to syringes, etc. But the test strips...that's about $3500/year.

So frustrating.

ANyone know what to do? She's a pediatric patient. Why would they not cover One-Touch? They are very popular. I don't even really like One-Touch of all the glucometers, I just need it for the Ping to the Pump!

~Just a worried frustrated parent trying to do the best thing.

2

Hi -

I would guess that if you make a formal request explaining that there is a significant danger that if your daughter and her caregivers had to use another meter and then punch the number into the meter human error could lead to hospital visits.

My insurance doesn't cover Freestyle strips but BCBS made an exception because I use a Cozmo pump with a built in Freestyle meter. You probably should ask your daughter's doc to make a formal request as well.

Maurie

3

I think while I'm "waiting" for the insurance to "see what they can do", I will be proactive and have our doctor write a little something. I know him pretty well as I work in the hospital indirectly with him, and maybe I can even write the letter myself and just have him sign it (?? since he's soooo busy ???)

4

Better check as well about One Touch Ping supplies (infusion sets,reservoirs) as well. If they are covering One Touch Ping supplies they should be covering One Touch strips. Your new insurance is going cheap on you. And not returning your calls is a definite no no. Talk to your boss, after all he is paying for good service with this new company and is not getting it.

5

You have a really good point. I did just order Animas One Touch ping insulin pump infusion sets and the new insurance did cover them. But I think I will bring that up, thanks, I didn't think of that.

6

That is an excellent point - if they cover the infusion sets, and not the supplies to operate the remote that works with the pump. Then it doesn't make sense. Could give you the basis for them to make an exception.

7

UPDATE: The insurance, I think, was finally tired of dealing with me. They decided to "override" the lack of coverage for the strips so I guess now they are covered.

What doesn't make sense though is they told me a 3 month supply of strips is $850.00 (since I need to meet the deductible). This doesn't add up because they strips are $50 for a box of 50. Roughly $1 per strip. Normally the bill is ~$450 for 3 months. Unless they put it in as testing 10 times or more a day...we usually test about 7, so close enough.

Anyway, I told the that price was fine. I have to meet the deductible anyway so... whatever. At least they are coving them. Seems real fishy to me and I don't like it. I've never had trouble with insurance before. I've always had insurance just cover whatever I needed when I needed it.

BENESCRIPT, ugh!!

Funny that they ask me if the price was ok. Like I have a choice? Am I going to decide, "well, it's too much. Forget it. We just won't test our blood sugar anymore. We only do it for fun anyway." (ok sarcasm....)

8

YEAH! VICTORY, at a price of course.