Problems with BLUE CROSS

I received a letter today from BLUE CROSS stating they are making changes to their perscription coverage of the freestyle test strips. They have moved them to a tier 3 coverage, which will increase my out of pocket cost for my test strips from 35 to over 100. Has any one tried to use a different meter? I don’t want to use a different meter because I will have to carry another device. Just mad at insurance companies right now.

BCBS recently sent me a similar letter.
My co-pays were previously $50 for a 3 mo supply, and they will bump to $80 for tier 3. However, I utilize the freestyle promise program so my copay is always $15 no matter what. Are you a member? I highly recommend it (it’s free, and you save money on freestyle (or freestyle lite) strips…it’s a no-brainer right!?).

btw, I am mad at the insurance company too, but the promise program gave me a little consolation :slight_smile: On top of that, BCBS made me “pick a new meter” and they shipped it to me for free (it was between some Accu-cheks and some Bayer products). That helped some too, b/c I could “stick it to the man” by making them ship me the free meter and strips, and then I can now give away that meter and strips to someone in need of them… :wink: Everyone wins lol.

I have BCBS but CCS Medical sends out my test strips with my pump supplies so they’re all charged as Durable Medical Equipment. This is how I get around their mandated use of Novolog as well and use Apidra.

off topic, but is there a good place to give away or donate any supplies I no longer need? I have 4 meters, pen tops, etc. that are still good, but I no longer need. I hate the idea of throwing them out. But they are starting to take up too much room… I would love any suggestions!

do you have the freestyle discount card? Just call Abbott to get you card, u get a discount everytime u need strips

Same thing happened to me with United Health Care, I was sooo mad! With the freestyle program from abbott the stips will cost you $50 a month, still stinks but better than $100(I was paying $15 with the promise program). Also make sure your Dr. writes your script for the max amount of times a day you test(ours writes for 8 times per day) this will allow you to get the most strips you can per month for 1 co-pay, depending on how many times a day you are actually testing you may be able to get by for more than a month. Let me know if you have any questions about this.

I do have the freestyle promise card. How does it work if you order a 90 day supply. I have only been using for a one month supply at a time.

Same process. I have my script written for a 90 day supply so when I purchase, it still drops it to the $15 copay. However, if you try to go in before a calendar 90 days (I think it may let you renew at 85 days, but I’m not certain on this), it will deny saying it’s “too soon”, even if your insurance will allow a refill to occur (that’s the only drawback I’ve seen)…

Has anyone else had trouble getting the Freestyle Promise program to reimburse you? They denied me at one point saying I needed to include the whole bill (I had submitted the bill to pay- and given them the top portion that had the $ amount on it).

I guess I’m unfamiliar w/ that method. I just hand my Promise program swipe card to the pharm tech when I’m paying at the register.
To my understanding, it’s run as an additional insurance (this is in the Walgreen’s computer system at least) and so it covers the difference between the copay I have through my normal insurance and the $15 copay that I have w/ the Promise program.
I’ve never had to submit any receipts or any other documentation…what is your normal process to get the lower copay through the program?

do you go into the Pharmacy or do you mail order?

Get a CGM, I use the Dexcom. Its free monthly for me on Anthem Blue Cross. This will move you from 10 strips a day to 2 strips a day. Plus you’ll get the benefits of knowing your BG all the time. Best thing since sliced bread.

Your out of pocket cost using the promise program can be as little as $15 per prescription filling with a maximum from the program of $50 (per prescription filling). If you go to a pharmacy to pick up your test strips, have them swipe your card there. If you use mail order pharmacy, you have to submit a voucher within 30 days of receiving the strips with your receipt and then they will mail you a check (or at least that’s been my experience).

For me, my co-pay with the mail order pharmacy is $60 for 3 months (as opposed to the $90 it would be at a regular pharmacy with 3 trips). With the freestyle program my copay is now $15 (with the promise program mailing me a check for $45). If my copay with the mail order pharmacy were $65 or more, the promise program would mail me a check for $50. My experience with mail order pharmacies is you pay 2 months co-pays for 3 months of supplies … plus they are shipped to you for free. I order my test strips at the same time as my insulin so they overnight all of it together at no cost. All the mail order pharmacies I have used have been through my insurance company and I found them by calling the number for the pharmacy coverage on the back of my insurance card.

I’m not especially loyal to Freestyle strips, so I have lots of experience using other meters. You do have the added step of having to manually enter the blood sugars in your PDM and the inconvenience of having to carry more supplies around, but if it was a significant savings I would probably use the strips covered at the cheaper tier by the insurance … with the exception of One Touch. (I hate the One Touch strips … just a personal preference.) You may even be able to save more with the new strips since both Bayer and Accu Chek now have discount programs as well.

I’m sad to hear Blue Cross has bumped the Freestyle to Tier 3 because I’m switching to them in August when I start my new job.

Hope this helps!

Hmmm…I have BCBS and I haven’t received any kind of letter, nor has there been any change in my co-pays. I do use the Freestyle Promise card, but also, one poster said BCBS won’t cover Apidra? I haven’t heard anything about that. Is it a state or regional BCBS plan thing?

BCBS is really a large network of different heathcare providers. I think someone once described it as like a heathcare franchise. There are some regulations they all have to follow but there are many rules that they can change or limit on their own. Just because one BCBS network makes a decision does not mean that decision applies to another BCBS network.

Haven’t seen that yet - hope I don’t - that really stinks! Thanks for the heads up - I will be on the lookout.

I received the same letter and I was able to solve by asking my Dr. for a prior authorization.

what did the prior authorization due???