How ofte do other T1D test per day and insuance limits

By mjhorgan Latest Reply 2014-03-04 18:26:44 -0600
Started 2014-03-03 15:38:35 -0600

Just curious how often others test, and If others have had the insurance companies limit the number of test strips. I have appealed to the insurance company for two years now and have had my limits increased both times. It is not an easy process to appeal but it is worth it.

5 replies

Trudie Ann
Trudie Ann 2014-03-04 14:14:27 -0600 Report

Being type 2 my insurance only covers 3 times a day. I don't think that's enough. You can't compare the before meals and after with only being allowed 3 tests a day.

Type1Lou 2014-03-04 12:38:18 -0600 Report

I test an average of 8 times per day. The key is to have your doctor specify on the RX a specific number of times per day which will cover the range of days for which the RX is written. It also doesn't hurt to specify how many boxes of 100 that means. If he only indicates a range, like "Test 6 to 8 times per day", the insurer is likely to opt for the lowest level so, six times per day for 90 days equals 720 strips and they would round out to 700 strips for 90 days. (Heaven forbid they should round up????!) I've learned this through my experience with Medco and Express Scripts. I think it's an area where insurers are penny-wise and pound-foolish. Of course, those who fraudulently get more strips than they need and resell the extra strips compound the problem for us.

mjhorgan 2014-03-04 13:23:13 -0600 Report

Right now I test 13 times per day. I was up to 14 times the year before this past year. My Dr wrote the prescription for a 90 day supply, specified the numbers of boxes. Two years in row the insurance company reduced the amount of tests per day to 6.5 times per day. Both years I had to go through two levels of appeals, which involved letter, supporting documentation and Dr's letters. Two years now after each annual review I have had my amount increase to 13 times per day. I brought to topic up with a friend who works in Boston and is an expert in the government regulation of the insurance industry . His response shocked me. He said that health insurance companies do not care about our day to day health when it comes to test strips. All they care about is the annual financial report to their shareholders. The CEO of these companies only care about the bottom line for that year. They will care about the bottom line for next fiscal year next year.

Type1Lou 2014-03-04 18:26:44 -0600 Report

Having spent 24 years working for a major insurer, I do know that insurer's do not like responding to state insurance department complaints. When Medco arbitrarily cut my 90 day supply of insulin from 3 vials to 2 back in 2011, I not only wrote to the State Insurance Department but also to the president of Medco…(see my prior post here "Medco makes my blood boil" for more details.) It got the results I wanted. There are times that insurers just make me want to scream. It's sad that we have to resort to this.

Silicone eyes
Silicone eyes 2014-03-04 09:46:57 -0600 Report

I used to be 4* a day, after my pump, it's more like 10. My work covers basic diabetic supplies at 100%, no trouble with that.

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