Shocking New Kaiser Test Strip Guidelines

Received notice in the mail today: As of January 1, Kaiser will pay for 50 strips/month for those non-insulin dependent and 150/month for those using insulin. That’s 1.6 and 5 strips/day respectively. I consider this a death sentence for many of us. I intend to challenge it. Including a lone picket at their Interstate offices if I have to. It is tilting at windmills, perhaps, but this is intolerable. Here’s the letter I’m sending as a starting place—copies to my own doc, of course:

December 18, 2009
To: Sean Jones, MD and Steve Logan, RPh
From: Judith Catterall, Kaiser Member
Re: New Diabetes Test Strip Policy

Dear Sirs:

I have received your letter about new test strip guidelines for diabetics. I have several questions:

  1. There are no diabetics who will benefit from a policy that does not allow us to test our blood sugar in relation to what we eat and how we exercise—insulin-dependent or not. So I would ask: Who WILL benefit from this policy?

  2. You say that this policy is in line with testing recommendations. Whose recommendations?

  3. You say that it is approved by your diabetes specialists. Do any of them know any real live diabetics who are healthy?

  4. Everyday there is another story about the epidemic proportions of diabetes. Why is your answer to this problem to make it more difficult for diabetics to do well?

  5. For any diabetic on any kind of med, you are promising them more dangerous lows and more complications. Is this your intent?

My doctor has okayed my strip supply for testing many times per day. Because of that my A1c is nearly normal. It works. I know exactly what everything I eat does to my blood sugar and can make intelligent choices. For the non-insulin dependent, your new policy allows 1.6 tests per day; with insulin, 5 strips. This is a death sentence.

Your new policy puts the lie to your ad campaign urging us all to THRIVE. No diabetic anywhere will thrive on this policy.

On behalf of all diabetics and their families, I urge you to reconsider this inhumane policy.


Judith Catterall

1 Like

And to the local media ?
Is Kaiser an Insurance Agency ?
Thanks for advocating , signed by someone who pokes a lot , has educated herself about diabetes and has NEVER been in the Emerge …living with diabetes for 27 years( and lives in Canada ) .

You know, insurance companies are actually gambling when they do policies like this. They are betting that you will be on SOMEONE ELSE’S COVERAGE when the complications from this policy set in. Save money now and damn the future! It is honestly obscene in my opinion

I am so sorry to hear about your mom, my dad was a WWII vet, also Pacific theatre, passed in 2000. Mom is still cantankerous tho, 85 and living by herself.

That is why a public option scares me so much. How long before it becomes an issue of how much we can pay in taxes versus how much our care costs?

Great letter, Judith. Does this new policy apply no matter what level of coverage one has through Kaiser?

Sending to the media is a good tactic, too – your local network television station probably employs a health reporter, and it might not hurt to find out how or whether AARP and ADA respond.

I bet the people who wrote the new policy also funded the “study” that advocates mammograms only after age 50 and PAP smears every three years…


have a good one…

dad didn’t talk much about his WWII experiences, but be happy to share what he did any time

Wonderful letter! An outrage, an absolute disgrace.

Kaiser, how about aiming your power & advertising bucks towards the manufacturers to bring down the cost of strips. Nah, better to limit the most effective & cost effective way PWD manage a disease. Better for people to end up hospitalized & worse.

THRIVE–I’d be banned if I wrote the string of obscenities going through my mind right now.

Wish I lived close enough to join your protest. Though not a Kaiser customer, I’m writing them a letter also. I’m livid.

What Kaiser’s address?

Hi Judith, I think you have a very good chance of our local media picking this story up if you notify them. News that generates controversy is something that generates viewers and health care is certainly one of the hotter current topics. Thankfully my insurance provides a better benefit. I encourage you to scan the letter you received and your letter in response and email them to KATU, KOIN, or KGW as soon as you can. You certainly can’t be the only one in our area who received this announcement today.

Also, I hope the media also stresses that if the test strip manufacturers weren’t charging so much for their products this would probably not even be an issue. Kaiser is no doubt forking over a mint to these companies. There is no question that cost is the motivating factor in Kaiser’s decision. But, the shame also lies upon the test strip manufacturers. Kaiser is guilty of choosing the response that threatens the well-being of their members. The manufacturers are guilty of charging astronomical prices. And we are left at the mercy of all of them. I’d like to think the test strip manufacturers have our well-being in mind, but the test strip industry is a huge cash cow for those companies. (And that goes for nearly everything we need to be healthy diabetics!) With diabetes on the rise, supplying diabetes-care products will become one of the most profitable areas of health care for these large and wealthy players to grab a piece of in our country.

Okay, now I’m worked up too! Where do we form the picket line? I stand with you 150%!!!

I cannot believe…they are so calculating. I am sure they crunched the numbers and figure for most patients…they will get sick on the next insurance plan. I admire you for your efforts to stand up to them. Maybe a sit in at one of their hospitals?? Get the media to cover it. Such a shame that they are unwilling to keep up their side of the insurance bargain. Good luck to you Judith.

I’m a child of the same generation & my blood is boiling. I’m ready for a protest!

Really, send me their address. I’ve got a letter composed in my mind. We have to stand together on this.

Thanks! I’ll send you my letter to the big K. The first draft is pretty inflammatory. Will get hubby the English professor to tone it down some:)

I wonder if there are Kaiser higher-ups who should also receive a copy.

We are a Kaiser Colorado family too but I have not received this letter for my Typ1 4-year-old. It will/would be very difficult to manage his extremely variable BG in his tiny little body with 5 strips a day or less.

Ain’t no way I can defend this companies position, but I have been fighting my doctor for six months about it, and have seen and understood his side of it, even if I totally disagree with it.

The problem is first off, as is obvious, greed. However, somewhere in the mix, is the fact that they people who set the policy are not diabetics, and they get their information from places like the ADA, which are not very much on the side of the diabetic community in many ways.

Simply put, from the ‘outside’ looking in, test strips are used to find out your BG levels, so you can adjust them with insulin. That is what they were invented for, and that is what the industry thinks they are used for. To give a non insulin dependent T2 test strips is a waste of money, because when you test, if you are high, or dangerously low, there is no way to adjust for it, so the manufacturers and insurance companies see it as a useless test.

That said, they are morons. What we as the community have to do, is re-educate them as to how the strips are used by T2 and those who do not use insulin. Even my doctor doesn’t get it. We use them differently than they think, and so anger and frustration is a good thing to a point, but education is paramount if we are to turn the thought process around.

My A1c and daily numbers are very tight as are many of us, because we test, test, and test again. I often test before I eat, and find myself a bit higher than I figured, so I have to alter my meal accordingly. That is how I control and “adjust” Same thing happens if I overdo it. I exercise until the numbers come back down. I also learned with testing that mornings are a bad time for carbs, for me. I can eat he Kellogs special K protein cereal, but not in the morning. Its usually lunch or part of dinner. Without strips, I would be eating too many carbs in the morning, and spiking past 140 without knowing it. I didn’t realize how much a simple cold would affect my numbers. The doctor never told me that. I found it out when it happened, and when I asked around. Given the higher numbers for a week or so, I had to back off on some of what I ate, or I would have gone too high, and upset that “magic” A1c.

Until we can rationally explain how much the testing has helped us, nothing will change, so after you vent against the insurance company, remember to provide data and explanations about why you need to be able to use more strips in order to keep tight control. My doctor only wants me to test once a day. When I ask when, he says it doesn’t matter, which shows right off that he is ignorant of how things work.

We are successful in controlling our numbers, because we know what they are, and although we cannot adjust them with insulin, we can adjust them with our exercise, and food choices at the moment. This fact is totally lost on most medical personnel. Valid logic is hard to refute, so just remember to use it calmly after you get your anger off your chest when discussing it with doctors and insurance companies, or else we look like we are just crazy and wasteful to want to test so often. My doctor now allows me four a day, my “insurance” will actually pay for 200 per month, but he won’t permit it, and said that in they summer, when I come around for another round of refills, he will cut it back to once a day, maybe less. I have that long to convince him of the error of his ways.

To change the topic slightly, so long as we are gonna trash the health care system and put in all new regulations and control, I would like to see people with life long diseases such as diabetes, given lifetime prescriptions, so we don’t have to have a doctor on call to do refills, and require us to come and pay a fee to their office, just to justify their existence. Its not like we are gonna get any better. Same thing with the A1c testing. The lab I have to go to won’t give me my number, and my doctor won’t tell it to me, until I pay the cash for an office visit. Something as routine and important as that, should just be, show up, get tested, email me the number, and let’s all move on. Why tie up the medical system with wasted office visits. Again, its because of greed and stupidity, but mixed in there is the simple fact that those in charge, just don’t understand the control of the disease as well as those of us who live it daily.


Now of course, don’t forget you have a state insurance regulator with oversight over Kaiser. In Oregon, they are at If you look through the site, your state has a consumer advocate and a place to file a complaint. You can appeal an insurance company denial, and if further denied, you have a right to external appeal. If enough people hassle them, they will cave. And Yes, Kaiser is an insurance agency in Oregon.

My God…if this doesn’t go to examplify that the world belongs to the young and healthy, I don’t know what does!!!
Be damned if you have been born with a disposition toward X…we are damaged goods. Why not just shoot us and get it over with!

Here’s my letter to Kaiser.

I am appalled at Kaiser’s new policy regarding limiting test strips for people with diabetes. Testing blood glucose regularly is the most effective means of managing this disease, in conjunction with insulin and medication. This short-sighted cost saving by Kaiser will assuredly result in more costly and devastating diabetic complications.

At the same time you’ve cut our best method of staying healthy, you are promoting THRIVE. Afraid I see inconsistency here and some would say hypocrisy.

Perhaps you could advise, to a Type 1 insulin dependent, how to best utilize the new five strip allotment. Should I test before meals or after since five strips are not sufficient to do both? Or, perhaps I should forgo testing before bed or omit morning fasting tests? There are occasions when meters do not give accurate readings. Retesting to verify results won’t be feasible under Kaiser’s new policy.

I will not have adequate strips to test when BG is plummeting to prevent severe hypoglycemia. I’ll have no data on which to base an informed decision. Since I have hypoglycemic unawareness, I hope not to go into a diabetic coma and die as I dole out the strips that help keep me alive.

I will not be able to test hyperglycemia to correct damaging high blood glucose because I won’t know the appropriate insulin dose to inject. I’ll be guessing and crossing my fingers that shooting in the dark doesn’t result in hypoglycemia that will kill me. I will not be able to test prior to driving long distances, nor will I able to test during exercise as my endocrinologist recommends. Since exercise is another critical factor in managing diabetes, I will be forced to give up this part of my health regiment.

Older adults and diabetic children are advised to test frequently. How can a mother manage her baby’s blood glucose with only five test strips per day?

Illness increases blood glucose levels, often dramatically. More frequent testing when sick is a necessity to prevent diabetic ketoacidosis (DKA), a life threatening condition. How do we manage illness without this most important tool?

At the cost of $1.00 per test strip, the expense of purchasing the additional strips needed to prevent losing our limbs, eyesight and kidneys to diabetes is prohibitive. It would benefit us all if pressure was brought upon strip manufacturers to make this a reasonable cost. Test strips cost less than $.10 to produce. An exorbitant profit is being made when R&R expenses have long been recouped.

Unfortunate that insurance providers do not take a Hippocratic Oath to “first do no harm.” What Kaiser has proposed is exceedingly harmful.

I urge you to reconsider your policy of limiting glucose test strips.

So well said:) I see office visits w/ the doc almost useless…sharing of information more helpful. I hope some day we do most of that by use of technology and we can live our lives…not spending most of it going to the doctor or hanging out w/ health care workers. How do you see US changing the system?? I have thought about this a lot…something I think us w/ chronic illnesses need to discuss and take an active part in.

The Canadian Diabetes Association has been advocating with our Governments , Federal and Provincial/Territoral for some time : spent $ 1,00 now and save $ 4,00 later. To my way of thinking : this includes finger poking …

I too received said Kaiser letter & nearly fell off my chair reading it.

There is one little sentence “Additional strips will be covered if prescribed by your Kaiser Permanente clinician or diabetes care manager” My Prescription clearly states “Test up to 10 times per day to prevent lows” so I get 300 strips per month, I’m hoping this will continue.

I rang the number they provided in the letter (503-261-7900) & left a message yesterday, they phoned back this morning when I was out so now we are playing phone tag. I will let you all know what is eventually transpires.

So get onto your Kaiser doctor & get your prescription updated