Pumps and Strips and HMO ignorance

From my new HMO, which now I’m not so thrilled with: We had submitted an authorization request for Accu-chek so I could use the Connect meter and try a pump vacation. Neither here nor there now because I decided to keep using my One Touch linked meter for my Revel for when I am pumping (that meter is no longer available and I like it).
With the auth. they want $187 per month for 250 Accu-Chek strips. I informed the case manager nurse that many have pumps that work in sync with certain meters and if they are not covering anything but One Touch, then those patients have lost that feature. Specifically I mentioned the Bayer and Medtronic relationship.
Well, the nurse tells me that we are in a very tiny demographic and there just is not a need for people to have access to different strips (in so many words). She said I just had more technology information needs than most people.
True enough, we need more ‘smart’ meters here in the US, but just hoping for that does not help other patients right now.
I am so frustrated, and about had it with these people.
This is ignorance. No she is not the pharmacy company for the HMO but she is in charge of the diabetes program. She is going to bring it up with them. The pharmacy for the HMO needs to wake up.
Un.Be.Lievable.
Laura in NM

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My husband and I actually have the pump that blue tooths to Accu-chek meter and our Insurance co won’t even cover them towards our out of pocket OR deductible. So we have completely lost that feature of bolousing or correcting for the exact amount we need

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That is so not right. I was telling this nurse that either the insurance, us or both pays for these pumps and no one wants a $6000 pump that isnt able to be used in the way intended. She didnt get it. She actually said I should go get a desktop computer program to use for my bolus advice.

If you talk again and the subject arises, maybe you could say, “I guess it’s hard for someone to understand who isn’t faced with making consequential diabetes decisions every hour of every day of every week of every month of every year till the day you die.”

I wouldn’t want her job!

I have a Connect meter that I used for a study that I participated in. Compared to my Freestyle meters, I found it to be inconsistent and not a meter that I would want to use longterm. I use a pump so I did not activate the bolus calculator.

As a Dexcom user, one of the ways I evaluate meters is based on how close the two initial calibration tests are. With Freestyle, the two tests are usually close-- like 130, 132. With the AccuChek Connect, sometimes the two readings were close. Other times it was 130, 105. Not good enough for me.

I use the One Touch Verio and last night I had 4 consecutive readings of 165 , 202, 150,180. Correcting based on most meters can be a total crap shoot. I loved my Free Style but my plan would only cover it while I was using a Cozmo.

Maurie

That’s sad. She acted like this is a feature very few people ever would need or want. I was so frustrated. The old approach to MDI it sounded like to me.

I might write a letter to their Pharmacy company just because…

Don’t get me started on how I miss my little Cozmo…sniff sniff…

Doesnt a lot of research show that Freestyle is one of the most accurate?

Just gave mine up this year. Used it for 8 years and loved it but it was getting pretty feeble by the end.

You might want to ask about the appeals process and if a letter of medical necessity from your endo is required. IOW, the endo says “this system is what this patient needs to have a better outcome in managing a chronic condition.”

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Well, I could but for now I found an app that will work with One touch or any meter so…

Have you tried to get a co-pay card for your strips? Currently, it’s the only way I can afford mine monthly. My cost per 400 strips goes from 150 to 30 with the savings card, and it’s good for 24 months. When it expires, I will switch meters to whomever has the best copay card at the time.

Well, this is what the Roche rep said should happen but my pharmacy said they did run the card and it only went from $187 to $100 per month. The HMO doesnt want to give the quantity I am used to either, 250 instead of 300.

It might be worth giving the Roche rep a call back and see if they can refund the difference. I have to do that with an insulin I use. It’s a pain, but the nickels add up every month. Best of luck.

No, he had no further ideas. I found an app I like and put it on my phone. Should be good to go soon.