So...today I received a letter from my health insurance/prescription plan carrier stating after Jan. 1, 2014, I will be restricted on the number of blood glucose test strips they will pay for every month. I pay $190/mo. just for just my prescription insurance plan. I am prescribed enough strips for 10 times a day,I always test 8 times/day, then have a few extra on hand. I won't be able to find out the "limit" till after 1/1/14. The letter states I "can accept the new limit, or pay in full or an additional co-pay for additional strips." I have had diabetes for 42 years and am a pumper. I guess the "Affordable Care Act" will be affecting everyone.
I would work on having your doctor prepare a letter waiving the limit and stating why you need the 10. That has worked for many people in the past. FYI I just started Medicare and they accepted my 10 strips and Medicare is super strict.
My Endo already writes a letter for me to get 10/day. The letter states," the supply limits follow the dosing recommendations set by the FDA". It will be interesting to see what the new limit is...I'm hoping a letter from my Endo will continue to allow me 10/day. Thanks.
I have found that insurance will waive most policy when a doctor writes a writ of medical necessity. My insurance was not covering my test strips anymore for One touch, because I use a pump that can communicate with my pump, they waived the restriction and now i get them.
So does it explain what it means by “pay in full or pay an additional co-pay”? Seems like that could mean 2 very different things
I just need to chill till I know more on 1/2/14. I need to be able to test when I feel I need it.."Test not guess", is so true. My Endo is great, I'm sure she will do all she can to help, even more than she does now.
They number limit is for T2 not T1. Get your dr. To write the 10 per day and challenge the new limit. Don’t know that the FDA has an recommendation about stips. There are some studies w/T2 concluding that testing >3 x a day made a diff. w/a1c
improvements. The result is that many ins companies have miss-construed it by lumping T1 and T2 as the same thing. The ins. companies need to hear that T1D IS NOT THE SAME AS T2D, and need different treatment modalities.
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I agree, I've never heard the FDA make a recommendation about strips, it isn't even their job to make recommendations about treatment practice. The FDA is supposed to make sure meters are accurate, but not how often they should be used.
And while there have been studies showing testing doesn't matter, I would interpret those studies as actually showing that testing with no purpose has no effect. When I was first diagnosed T2 I was told to test and report the results to my doctor. My doctor ignored my logs and only focused on my A1c to modify my treatment plan. So of course testing didn't matter, my doctor didn't even look at the results. And the biggest failing. Nobody told me that I should "Eat to My Meter." OMG, how whacked is that. T2s need strips to learn how their blood sugar is affected by various things, particularly carbs in their diet. Once they learn about things, they can probably get by with less strips.
And while many T2s don't need to test 10 times a day, if you are a T2 on insulin like me, you need to test just as much as someone with T1. I would never inject rapid insulin without knowing my blood sugar and I don't want to drive or do other potentially dangerous activities without knowing my blood sugar.
Insurance companies are cheap. They want to low ball all of us patients. If you need to test 10 times a day, your doctor can write a letter of medical necessity and get your strips covered (in most cases). Some plans, like HMO's, enforce draconian conditions on doctors and make it difficult to get a decision of medical necessity. But in the end, if you medically need something, it isn't the place of the insurance company to make the medical decisions.