Insurance Owns My Health and Wallet

Chris Clement
By Chris Clement Latest Reply 2012-09-28 00:54:16 -0500
Started 2012-06-05 16:50:58 -0500

I invested in my Animas OneTouch Ping under my previous insurance company. I always got the meds and supplies I needed with no hassle; well covered and pretty affordable co-pays. But I switched jobs recently, and in effect, health insurance companies. The new insurance has stated that Bayer is the preferred supplier for test strips, so there was no coverage for the OneTouch strips I require to use this costly equipment I invested in. I was able to get special approval for partial coverage, but my test strips will costs me double what they did under my previous insurer. So my choices are:
1- buy a Bayer tester and not use the equipment I am invested in.
2- pay way more out of pocket monthly than I have been (aka get ripped off).
3- stop testing, deteriorate, and blame it on my insurer.
I'm leaning toward 3…
IMO, it is an unjust display of insurance company power to say they know better than my doctor what supplier I need. I pay them monthly only to be told I am limited in my options when it comes to managing my disease, and I have no way around it. They apparently own me, my health, and my wallet.

Anybody successfully fought this injustice before?
End rant.

16 replies

rcmodelr 2012-09-28 00:49:42 -0500 Report

Try this… I just got an email about it yesterday…

It's for a One Touch Assistance program designed for people using an Insulin Pump system like Animas or Medtronic's, that use One Touch meter to work with the pump. It's supposed to reduce your test strip co-pay by up to $45 per month, but says you'll always pay at least $5.00 per month co-pay for your One Touch test strips.

rcmodelr 2012-09-28 00:54:16 -0500 Report

UNFORTUNATELY, the program says it will reduce your co-pay for up to 15 months, but expires in December 2013, which is only 15 months away, if they'll allow you to send in a rebate claim for December 2013 after you receive the bill some time in January or February 2014… Otherwise, it's effectively reduced to 13 months unless they'll let you print the rebate and have it apply to one or more of the orders you've already had filled.

Nana_anna 2012-06-06 22:26:51 -0500 Report

Insurance companies think they have power over you. They can choose what to pay for or not. We have been ending us getting the bills in which we pay more and insurance companies pay less. I hate it, and I don't think they know how to deal with billing to begin with.

red flower lady
red flower lady 2012-06-06 14:56:08 -0500 Report

Can you not just use a different meter with this pump?

Chris Clement
Chris Clement 2012-06-06 15:09:46 -0500 Report

Not in the same way, but yes I can use a Bayer meter. However, the money I spent on my complete system, the insurance company's lack of support for what I already have, and the unrealistic control the company has over my d-management, are the issues here. I can use whatever meter they want me to use, but it will not sync up with my pump, which defeats the purpose of my technological investment.

red flower lady
red flower lady 2012-06-06 21:18:12 -0500 Report

Have you asked your dr to get the approval by your insurance, they can get it done better by writing why you need the test strip( mediaclly necessary for your pump) or writing the prescription of as ordered, which means they can't substitute. My dr has done this for me and yes it took almost two weeks to be approved. My insurance covered the pump, but not the insulin that was needed for it, the dr and the rep for the pump dealt with the insurance to get it covered. It is a unit that works together and if they don't cover it, are they willing to cover the replacement of a pump and supplies they do cover?

Harlen 2012-06-06 12:23:22 -0500 Report

I feel for you ,as a pumper I know how hard it is to keep things going
I have the medtronic pump and it works great and the onetouch strips are coverd thank god .
I would call the ping hot line and tell them whats going on ,they may be able to help ???
We all need to rant from time to time so go for it when you feel the need my frend .
Best wishes

granniesophie 2012-06-06 10:25:53 -0500 Report

Understand rant and empathize!! I too, would lean toward #3, but getting that sick when you really don't have to truly sucks.
Yes, big phama has us by the ba—s (even those of us that don't have them!!) and we are going to see it get worse as we are more and more controlled by government and the pharmacetical companies. Doctor's hands are tied-the practice of medicine is no longer a noble profession, it is something that is totally controllled, and any thinking outside the box is discouraged!
And THIS rant comes with the disclaimer that this is my opinion, and my opinion only, if you don't agree with me, it doesn't hurt my feelings at all :)

Nick1962 2012-06-06 10:07:47 -0500 Report

From my understanding, the Animas OneTouch Ping is a “Cadillac” of a pump, and I could see why anyone would want one. Do you need this specific unit?

Chris Clement
Chris Clement 2012-06-06 10:52:15 -0500 Report

It really is a superb unit. I only 'need' this because I already invested in it and can't go back. The point of the Ping is that I can test on my OneTouch ping meter and right from there say "cool, gimme this much insulin" and it will do it remotely. If I have to spend a ton more on strips for it, I am left with a difficult situation. I, with my doc, should be able to decide that this is the best system for my healthcare, and the insurance company I pay monthly should say it's good. I mean, we're talking test strips here. I bet the Bayer strips are roughly the same price as the OneTouch. It makes no sense to limit me on this.

Nick1962 2012-06-06 11:16:44 -0500 Report

This unit, from what I’ve read is really ahead of its time. I imagine this is what all pumps will be in a matter of years. Unfortunately (for you), you had a very generous insurance plan at your last job which could have been linked to this device as a preferred manufacturer for some financial reason behind the scenes. One way or another, you’ll pay for that unit and supplies whether it’s a direct cash outlay or in the form of premiums/copays. Does your new insurance have different coverage/deductible options? This is one reason our health insurance is with my wife’s company rather than mine. Mine is small group insurance and doesn’t cover such “upgrades” on equipment to keep costs low. Hers is a huge group who figures better equipment means less visits/complications so they don’t mind springing for it, and it’s spread over a wide base of premiums.
Going on a “hunger strike” as in option #3 might not be the best thing in the long run. I think the insurance company would come back and say you have adequate treatment options. Have you looked into third party insurance?

Chris Clement
Chris Clement 2012-06-06 13:58:17 -0500 Report

I was mostly joking about option 3, though this situation is not too encouraging. Being required to double my budget for test strips is demotivating. It's too much. Third Party insurance would only escalate my monthly premium spending; i'd be better off just buying the test strips. Plus, it' would make me dependent on the superiority of another insurance company.

Nick1962 2012-06-06 14:57:38 -0500 Report

That is one of the downfalls of the cutting edge equipment. Like Harlen said, check with the manufacturer. If they knew that strip cost could be a limiting factor for folks making the investment (and I looked at the price, it is a big investment), they may hook you up somehow or they may lobby your ins. co. BIOUSA may have them also

Nick1962 2012-06-06 17:05:21 -0500 Report

I've put this up before, but you probably missed it. Sice my PCP says i no longer "have" to test, he doesn't write scrps for supplies and I pay out of pocket.