Nurse-by-phone coaching?

BCBS has mailed me a few invitations to join LifeMaster’s diabetes disease management program. It seems like a call center of nurses who coach you over the phone in diabetes management on a regular basis.

I’m hesitant to participate for 2 reasons:

  1. Type 1 diabetes is so complicated, and typical canned education/coaching is so focussed on Type 2, which can be really frustrating. Is this nurse really going to be able to discuss how my thyroid and insulin antibodies are making me brittle, and how to reduce my standard deviation in after-dinner BG’s?

  2. BCBS is a business, and the less intimate information they have about me, the better. I’m a very compliant patient, but when doctors and nurses can’t explain a bad A1C, they usually just shrug and assume poor lifestyle choices. I don’t want my insurer doing the same.

Does anyone have any advice for me? I do need all the help I can get, but I just don’t want to make a mistake by participating in this program.

I too got lots of letters and then calls about this. I finally did it, and it was not any help at all. I have had type 1 for 42 years, and I’ve been lucky to just have a few complications. I’ve never been DKA, and never been hospitalized as a result of a diabetic type of event. The “nurses” I talked to were not very knowlegable on type1, and seemed to not believe me when I said I’d never had a heart attack or DKA, and that on a normal day I test my blood 10 times. They had no clue about pumps, either. They want to ask you a lot of questions, and as I remember it took a long time, and I was dying to get off the phone, and I was wondering what they were going to do with the info I gave them.

For keeping your motivation up, I find nothing has helped me more in these 42 years than the TuDiabetes community. If I need medical advice, I call my doctor.

Awesome advice, thanks Marie!

Blue Cross Blue Shield of Illinois administers the health insurance program for my self-insured employer. I also received, over the last few years, mail invitations from them to consult with nurses about my diabetes using the telephone. I don’t think it was called “Lifemaster’s diabetes disease management program,” but it sounds as you describe.

I read over the information and thought about it. I concluded that my best health interests conflict with the corporate goal of turning a profit. I could never fully trust their advice because I would never know how much of it was motivated by their profit goals.

Given that conclusion, I tossed their offer into the trash. I’ll place my confidence in health care advice with my doctors and with my continuos effort to fully inform myself using trusted sources. I value the experience and advice from the TuDiabetes community. I also try to keep up with diabetes and other health info found on webites like the Juvenile Diabetes Research Foundation, the Center for Disease Control, and the Mayo Clinic.

Marie, your experience confirms my conclusions about this type of service.

Grace, thanks for raising the issue.

I believe that any information that one relies on for something as important as health should be viewed with an appropriate dose of skepticism. This includes info received from a trusted source like a doctor. In the final analysis, you are the one that will live with any consequences, both bad and good.

I have never of this before. Sometimes bad or high A1C isn’t your fault. Too many low blood sugars will make you have high A1C because your body/liver is dumping sugar in your blood stream to make your BG come back up. Your body/liver can’t tell how much sugar to put in your blood stream so it puts too much then you have a rebound of very high BG. I’m not foresure I explain this correctly. You don’t have to particilate if you don’t want to unless they say you have to because of insurance reasoning. I know BCBS has a class on Diabetes once every 6 months in Kansas but I don’t go to them because it’s mostly for Type 2 and I’m Type 1. The first one I went to they didn’t talk about Type 1 if they did it was very short. Anyway, how can this help a Diabetic? If you are sick, you call your Endo for help. Well I do becuase my endo is 4 hours way and he can tell me if I should go to the ER to get IV fluids in or not.

I don’t think it ever hurts to join up. However, do not expect really great things either. As with all of these insurance programs targeting disease, it is basically an information source. That is, if you do not know how to do simple things they help out. In Indiana whatever you discuss with them is kept away from the plan sponsor. I got into one once and they bugged me to death, on the other hand they were impressive when I asked a question.

rick phillips

My Anthem insurance has the same program as part of BCBS. They’ve been quite assertive about getting me to participate. I got a packet of forms to complete & they frequently call. I’ve ignored all their efforts.

Maybe this program would be helpful for semi-emergencies when people may need an answer quickly & they can’t reach their doctor. Or, for somone who may not know what to do for a PWD in their care.

I’m with you on not wanting my insurer to know any more than they do already. I also don’t trust that their nurses will be of any real help.

Hi Grace, As much as Bsbc have good intensions of offering these services to help patient manage thier diabetes it does not come close to both the results and the emotional help that a face to face interactions with a healthcare provider ie diabetes educator, provides a patient. These programs are created because of two things, 1) the lack of access to local diabetes resources such as endos and diabetes educators and 2) cost cutting by health insurance. It is definetly not for everyone and it may help some people but in our experience it has benefited few and most feel it to be intrusive. My advise is to ask your doctor about diabetes education center in your area that can give you the support that you need to manage your diabetes.

Oh, I say don’t bother. I enrolled under Anthem BCBS of Virginia when my husband had insurance through them this last year. It’s so tailored toward type 2. Our plan’s version was an automated system that would call me periodically and ask me questions and I’d have to press 1 for yes, 2 for no, etc. They were asking stuff like:

Do you understand the importance of getting an annual A1c check?
Do you test your blood sugar everyday?
Do you take medications for your diabetes?
Do you understand the importance of a good diet?
Have you seen your health practitioner in the last 6 months?
Have you had your eyes checked in the last year?

It felt like a waste of my time. I have an A1c done every 3 months, test a billion times per day, etc, etc. I was hoping that enrolling in it would give me good standing with the insurer so when things like CGMS and pumps came up, they’d have it documented that I was well-controlled, but in reality, it was simply annoying.

Your time is better spent on diabetes education from CDEs, dietitians, books like Pumping Insulin/Using Insulin, clinical training from device suppliers (pumps, cgms, etc), and MOST IMPORTANTLY (and cheaply) ---- TuDiabetes friends! If you need help, ask. These folks give better maintenance and life advice than any insurance company nurse with whom I’ve dealt over the years.


I suspect this would be an assest to one of two people. The first is the new diabetic, I can see how the services woulb be super important in that instance or to a fall off the wago diabetic. Someone who has said, look, I am not taking my meds and I will eat what I want. In both cases the services would be helpful, but not redemptive.

rick phillips

It’s amazing that any company would actually consider any of that helpful… considering how far BELOW the current standards of care for all diabetics all of those questions really are.

Maybe ‘non-compliance’ is really much more rampant than any of us imagine? I think as T1’s were kind of in a unique situation - we rely so much on our doctors for the ‘stuff’ we need (insulin, strips, pump and CGM supplies), that avoiding seeing a doctor for any length of time just doesn’t work very well…

Thank you Marie for filling me on this. I have been hesitiant to do this and have just recently decided that I was going to finally get back with them. I am NOT going to now. I figured it was going to be geared towards Type 2 and probably a waste of my time.

I agree with all of you, totally. So nice to be around like-minded people! How unusual for a Type 1. Shawna, I agree that sometimes a high A1C isn’t your fault. Terry, we are our own doctors. Gerri, they’ve been really assertive with me too. Luckily they somehow have a wrong phone number for me so I just get the letters. Rick, I collect too much information about diabetes as it is and the coaches would only be useful if they helped me sort through it and focus on what works, rather than just adding to the pile of pamphlet-style facts. Tony, you are reminding me that I really do not have the relationship with my CDE that I want (at least a weekly e-mail exchange). Melissa, thanks for the list of questions - they are a total dealbreaker for me. Sarah, nothing makes me crazier than a rushed doctor who writes me off as being non-compliant because she probably sees that a lot. Mike, I’m with you, and have decided to ignore them :slight_smile:

I trust BCBS about as far as I can throw them (trust me not far), the only thing I trust less is the government, I too have been invited and for me personally there is no way I would do this. I want as little interaction as I can get away with with them… Just pay my bills per the plan coverage right and on time please (no they do NOT do a good job of this either–at least in my and my dr’s/suppliers experience)

well, at least they haven’t contacted me since.


I get calls from them about every 10 days. Annoying! When I didn’t submit the first pile of forms they sent to “help them help me manage my diabetes”, they sent me another two weeks later. I’d tell them that I’m not interested, but figured I’d get a demerit for being a non-compliant “bad” diabetic:)

It’s intrusive to say the least.

Generally I like the idea of a coach or a nurse that can help me navigate having a chronic disease. On the other hand, I don’t feel like I can trust an insurance company. I have an assigned nurse with my insurance and I will converse with her about my care and enlist her help if needed. But I consider everything I tell her to be public. If I tell her I am depressed or drinking, I have to assume that that will become public knowledge of any insurance company or future employer. I will carefully consider what I divulge to such an individual.

Now on the other hand, if you have trouble with your doctor, your blood sugar is not controlled enough and your doctor does not seem to care, these coaches/nurse can do wonders. They can talk with the doctor, find you a new doctor and even cut through some of the red tape getting the care that you need.

But understand, in the end, they don’t work for you, they work for the insurance company which does not always have your best interest at heart.