5 weeks and maybe my PCP’s staff will have the referral done this week. I called, wrote a letter and finally scheduled an appointment for today. Last week felt like I’d been swallowing flaming swords so it wasn’t all about the referral and the staff tried but couldn’t figure out the docs who were only accepting some new patients problem.
The appointment was a real hair puller. We landed on an in network GP MD that is also a CDCES. https://www.drgdiabetes.com/ I’m not excited expecting the worst but to my doc’s point, she just has to do the paperwork as long as my A1C and TIR are so “good” and I keep up on the ADA standards of care.
I decided while I was waiting for the appt with the CDCES I’d go after my health plan for not having enough endos in network. Mostly because I really don’t think I’m going to be able to rely on the CDCES. I found California has a patchwork of protections that aren’t bad so I filed a few grievances. If I have any success I’ll make a post about them. Probably have a better chance of winning the lottery.
Had to say something, dealing with health plans isn’t fun. I’m out of refills on insulin prescriptions making October 1 feel ominously close. Unlike Tim’s situation I’m sure my PCP will take care me if he has to.
You might think of the problem as “not enough endos in network” BUT really there’s a big endo shortage overall.
Paying for an out of network doctors office visit isn’t the hugest financial burden but it isn’t a small cost (typically $150 in my area). The good news (at least for me) is that labwork for out of network doctors is covered by insurance. (At least what would be covered anyway.)
In my case - I went from my “large but now shut down endo practice” to a very large research hospital with large endo department. It’s about an hours drive.
I got lucky - my new endo is herself a T1! She had no problem “padding out” my insulin prescriptions so I could start rebuilding my stockpile (which had gotten thin while I didn’t have an insulin prescription) again. We talked about the latest generation of pumps including what she uses.
One thing I learned in my visit: the standard of care for a well-controlled T1 seems to have relaxed from an office visit once every 3 months to once every 6 months in the past couple of years. ALSO was told that A1C’s every 3 months are no longer required for an insulin using diabetic if they are on a CGM. I’m not sure if these are insurance requirements (I’m not on Medicare yet) or broader.
Oh good golly gosh its been a day. I mean cheese and crackers!
Lets start with the good stuff. Tim that’s awesome you got a great endo. Your idea to check Universities with medical schools is great and yes, I have no problem taking the train to see someone once a year and doing another visit or two by video. I checked and none are in network for me and I’m not quite ready to pay twice for health care. That’s going to take some personal growth. Maybe next month.
Today I went for my appointment with the CDE. Which didn’t happen. They rescheduled for the last week in July, didn’t apologize or take responsibility.
The CDE is 5 minutes from my old endo’s office, who left a VM last week saying they got a referral and to call to schedule an appointment then wouldn’t schedule an appointment or return my calls. So I went to the office to schedule an appointment. Turns out my insurance company called them which is weird and they were trying to make me an appointment with an internist they have working in their endo department. When I asked about an appointment with the one remaining endo and they offered October 14th I said no thanks I’ll be dead by then because my 90 day supply of insulin runs out on the 1st. I know, T1D leads to a slow death, I was exaggerating to make a point. 10 minutes of digging later they found my old endo had ordered prescription renewals be sent and her staff never did it. They said they’d do it.
The CDE only sent a 30 day prescription for dexcoms. She also said I was going to have brain damage from 60-70mg/dL BG 4 out of 14 nights. I can’t abide any doctor who thinks threats are an acceptable way to try to change my behavior.
And I tried to order insulin from OptumRx and found the novolog prescription the endo office sent was for pens, not penfills and only for 1 box not the 3 needed for 90 days. The Lantus prescription was 1 box instead of 3 also.
Gotta admit, I’m a little sad. Maybe the molasses and ginger ice cream I picked up tonight will cure me.
