so i found out today that my health insurance (BCBS thru GM) does not cover any sort of test strip. i was informed that i could file an appeal but that will take upwards of a month to process. in the meantime i have enough test strips for 2 maybe 3 days and i do not know what to do. i have the money to go buy them over the counter but they are so expensive i’m trying to find some kind of alternative or discount program that will help me even though i do already have prescription coverage… any thoughts??
I think you need to check again. I would be really surprised to find that BCBS is not covering testing as a type 1 as prescribed by your doctor. Have your doctor write you a prescription to test 10 times a day. If your insurance fails to cover that they aren very likely violating the law. I am pretty darn sure that Michigan state law requires that test strips under a doctors presciption be covered. You need to talk to a person. Make sure that they give you their name and make sure they are very clear you are writing down their name. Ask them to make a tape recording of the call for legal purposes. And make sure that they know that you will be talking to the attorney general should the discussion not go well. Here is a summary of state laws (http://www.ncsl.org/IssuesResearch/Health/DiabetesHealthCoverageSta… and http://www.isletsofhope.com/diabetes/state-law/michigan-1.html).
I have found that often “mistakes” are made when insurance companies “volunteer” to cover things, but that a firm and informed tone can get you the coverage that you paid for and are assured by law.
Good luck.
I don’t know about MI law, but in MA and many other states, there is a law that explicitly states they must cover test strips with a prescription. Of course there are limits (in my case, I’ve nearly reached my $ max for the year) and BCBS of MA limits strips to 300/month, even with an RX. Look through your Explanation of Benefits and call them!
I agree, you need to investigate this more! Sometimes your Dr. can give you some spares or some to help get you thru. I would definitely appeal and if you win they should reimburse you for what you’ve spent! We have HAP thru GM and everything changed the first of Jan. Everything was covered 100% before but now I have no idea! We have a health savings plan and now have a deductible we must reach before things are covered. I picked up my 1 month supply middle of Jan and they said they would bill HAP and wait to see what happens. Still waiting.
I would appeal. I would go to HR and have the look into it. Could it be the brand that is not covered? Some insurance companies have preferred brands.
Find out who it is that isn’t covering the strips, BCBS or your employer.
An appeal may work if it’s BCBS, if it’s your employer they will have to either change their contract or the policy rider and you’ll have to work on your HR dept to get this done.
So, do they not provide a wheelchair for a paraplegic or a cain for a blind person also? This sounds like they don’t know the difference between Diabetes and Diabetes. Your MD needs to step it up and get involved as your advocate with the Ins co.
Agree with everyone’s suggestions. Never heard of BCBS, or any insurance company, denying test strips for anyone using insulin. Keep calling, do not take no for an answer, or accept waiting a month for an appeal.
Also check with your state insurance commission. They oversee insurance providers.
Ask your doctor for strips. They get free meters, strips & insulin also.
Sorry you have to fight this.
That does seem kind of weird for them to say they dont cover them but file an appeal. So my question to them would be “they dont cover me” or is that a company wide thing where no one is covered now. I would call back and talk to a different person or a superviser. I have had issues with one person screwing up what I should have covered by my insurance and then have a different answer for someone else. Also you should have a booklet that insurance company gives you that tells you upfront what they do cover and under what conditions. i always get a book the size of a phone book telling me what i have covered.
I also have a back up meter when I run out of the more expensive strips that I can afford. I have a wavesense presto that I got at wal-mart for 14 dollars and the 50 strip bucket is 22 dollars. It still costly but beats paying 50 dollars for a bucket of accu-check aviva.
Hi, I was just saw this post on the main page. Although I am not T1, I am T2 and have to check my glucose levels 4x a day… I also have insurance with BCBS (with a different company) ---- they DONT cover test strips!!! I’ve tried to appeal, but have not gotten anywhere with it…
Meanwhile, you might use a Relion ultima meter for $9 and test strips are $39 a hundred at WalMart. I use it when I run out.
definitely try again, as others have said. I have BCBS and my doctor had to write them a letter to say that I needed to test 10 times a day. They also only cover Accu-chek or One Touch. Here is a list of different discounts you can get as a TuDiabetes member.
Not sure if this applies to you or not, but I have read online about BCBS of MI only covering the cost of testing supplies that are ordered through approved mail-order pharmacy programs. Not sure if this applies in your situation, but it may be worth looking into…
I have now talked with three different employees that have all told me the same thing: absolutely NO test strips are covered. in the meantime i have filed an appeal. I also just filed a claim with the better business bureau bc it is part of MI legislation for them to cover my test strips. I do not understand how they will cover my pump supplies but not my test strips BAHHHH! thanks for all the input 
So sorry! This is crazy.
Have you checked if there’s a state insurance commission in MI? Also contact your state representatives for help.
The Better Business Bureau has no authority to enforce or change anything. They’re a business group with no power. They’re like the Chamber of Commerce–useless.
I have BC/BS of Idaho and mine does not cover test strips either however I was able to find a loop hole…They will cover “medical equipment” so I had to purchase my strips through a medical supply store. Here we have one called Norco they carry equipment like wheelchairs etc. I had totake in a prescription. They only carry the cheapest strips but the meter was free so I was happy with that. I hope this info helps!!
From the State of Michigan Website (http://www.michigan.gov/dleg/0,1607,7-154-10555_13648-26242–,00.html#diabetes):
"Michigan law requires health insurance companies, health maintenance organizations, and Blue Cross Blue Shield of Michigan to provide benefits for blood glucose monitors, visual reading and urine testing strips, lancets, spring-powered lancets, syringes, insulin pumps and medical supplies required for use of an insulin pump. They must also provide payment for self-management training and education if prescribed by an allopathic or osteopathic physician and determined to be medically necessary. There are some limitations on the educational training reimbursements.
A health insurance company and a health maintenance organization that provides a benefit plan including outpatient prescription coverage must also pay for insulin, nonexperimental medication for controlling blood sugar, medications used for foot ailments, infections, and other medical conditions of the foot, ankle, or nails associated with diabetes. Blue Cross Blue Shield must cover these same medications regardless of whether outpatient prescription drugs are otherwise provided in the health benefit plan.
Individuals who receive their health insurance coverage through a self-insured employer may have different benefits for diabetes treatments and education than those listed above. Self-insured employers are regulated under federal laws and do not have to meet the requirements of Michigan law."
Now, either they are in violation of the law, or (what is more likely) is that GM is self-insured and therefore exempt from this law. They would then be covered under Federal regulations under the ERISA. I can find NOTHING about the regulations through the ERISA however.
Hope this helps…
Have you tried to go through your DME benefit, rather than your pharmacy benefit? Through a DME benefit, the strips may be considered “supplies” - at least through my BC/BS plan in NY. If I order through a supplies provider (i.e. Mail order), they are covered 100%. Through my pharmacy plan, co-pays and quantity limits are imposed.
I buy them online, where I can get them at more than 50% off. I use google shopping for this… Sometimes, you can get em off ebay, just make sure they’re not expired, or too close to expiration. I bought 200 strips for $66 the other day, this way. Not the cheapest thing in the world, but it certainly kicks the pants off of buying them at a store.
I would be chagrined to think that your insurance company is denying what is a medical necessity. Did you contact your insurance company or did you rely on your prescription being rejected when presented to be filled? If the rejection is from your insurance company, you should definitely appeal because the coverage, when granted, will be ongoing. In the interim, you can call the manufacturer of the test strips that you are using and tell them that you must test your blood sugar, and that it is a financial hardship for you to buy the strips while you are processing and waiting for a response to an appeal to your insurance company. Many companies will respond positively to this request (hopefully, your income is not too high). If you have difficulties with this, then, as someone else suggested, ask your doctor’s office for samples.