The back nine
As I write this (Tuesday night), I’m down to my last nine Bayer ContourNext strips.
You may remember my saga with the test strips, and insurance battles, from my last post.
Actually, that’s not quite accurate. I’ve got 22 unopened boxes of strips (for a total of 1100 fingerstick tests; or if you play by the rules, 1078 fingerstick tests and twenty-two control-solution tests). I’ve also got a return-label to send those strips back to Edgepark, and a standing prescription to get 22 identical boxes of strips from CVS Caremark. So I can’t quite open those boxes just yet, or it could cost me dearly.
Last Thursday, there was a friendly message from CVS Caremark on my answering machine (yes, I still have an answering machine; don’t laugh) from their “Diabetes Choice” division. You know, because having T1D is a choice. Apparently. They gave me a reference number and asked me to call them back. When I did, the cheerful woman on the phone made me an offer which she thought I couldn’t refuse: while my Bayer strips would cost me $80, they offered me the same amount of OneTouch or Accu-Check strips for just $50 — and they’d even send me a free meter if I chose to do so!
I was livid. Yes, I know of cases — far too many, to be exact — where insurance dictated which brand of supplies (or insulin!) someone could use, but it had never happened to me before. Suddenly, my wife’s company-sponsored “awesome” medical insurance was becoming more and more mediocre. And I began contemplating enrolling in the plan at my own employer again (the window of opportunity is still open) – though something tells me that can’t work out well. I told Mrs. CVS that I’d take time to think about it and call her back. Several days later, that order remains “on hold.”
Are the OneTouch strips really that bad, I found myself contemplating? Could I deal with bleeding more blood into a clunky old meter that I can’t read at night? Should I give the heralded Accu-Chek Nano a test-drive? It won’t talk to my pump, but Roche has been flaunting that you can (without using the actual catchphrase), Strip Safely with their product. And accuracy has been more in the forefront of my mind lately.
No, I wanted my Bayer Strips that I’ve sung the praises of since my original mediocre review from last November. It’s not perfect, but it’s the best I can get.
Back to the medical insurance company. After logging into their website, I clicked through and found the page that said the medical, and not the prescription plan, covers supplies for self-treatment of diabetes. Then I called them up to call them out on it. The woman I spoke with placed me on hold while she checked my coverage. That led nowhere, so she put me on hold again and transferred me to someone else. He pointed out to me that, under the heading of “Diabetes care stuff”, it says that the medical plan should cover it at 100%. But under the heading of “stuff the medical plan should cover”, diabetes stuff isn’t there. Not his exact words, but that’s the message as I understood it. He believes I should be covered and that my original claim shouldn’t have been denied.
So he’s going to transfer me to some sort of “advocate” (who happens to be an employee of the insurance company) to liaise with my wife’s employer and get to the bottom of this. I should get a response in five business days, which will be this coming Friday. As for the FSA-reimbursement check, he said umm….uhh….well…… I interjected and suggested we just take care of this coverage issue first, and cross that other bridge when we come to it. I figured I’d let him off the hook — he was being helpful. And besides, I’d love to cash that check. (Which, he told me, I have 90 days to do. If “promptly” means “within 90 days” in insurance-lingo, I can believe it.)
Now I’ve got nine strips left — borrowed from my “emergency pack” that I can comfortably use. I think it’s time to crack open those OneTouch strips and fire up the old meter for the next couple of days.
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I know this may sound like petty complaining, and if it comes across that way, I apologize. Truth be told, $80 for over 1000 strips really isn’t a bad deal, and I know plenty of PWD’s have worse coverage, or none at all, for their test strips. What really ticks me off, and is the reason for my writing this post, is how convoluted and flawed the whole system is. Ultimately, the only ones who are losing are the patients. The healthcare administrators, indirect retailers, prescription plan managers/drug dispensaries, and manufacturers are all in it for profit. But it’s their convoluted operating methods — not to mention the side-deals they accept from manufacturers to incentivize their brands — that drive up administrative tasks, increase expenses, lower the quality of care received, and ultimately lead to higher costs for people like you and me. There’s a simpler, more efficient, and more effective way to do this. I wish I knew how to put that better way into action.
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My CGM just alerted me to a “High Predicted” and my trend-line is heading northeast. In a moment I’ll be down to eight strips.
Posted on August 14, 2013, in D-Finance, Personal and tagged insurance. Bookmark the permalink. 3 Comments.
I think we have the right to complain no matter how good or bad our coverage may be. I’ve been dealing with recent insurance issues myself that I never have before and they suck to be quite honest. My feeling is that we may begin to see more changes (and not for the better) due to new healthcare legislation. I hope you can get your issues resolved and soon.
I don’t think this is petty.
No, not petty.
not at all. coverage aside, it’s frustrating as hell and we all get it.
I hope you can crack those boxes open soon. I do.