I know the thought of calling your insurance company may sound less appealing than poking yourself in the eye with a hot ember — but, if you’re results driven it’s the way to go.
Insurance companies are quick to ‘get your goat’ — true for even the most patient of people calling to inquire about some kind of denial or another.
We’ve all either learned the hard way or have mastered the art of finagling what is rightfully ours — a rite of passage through all of the red tape.
Obamacare is wonderful in the respect that people with a pre-existing condition can now apply for insurance and are guaranteed to get it, albeit, may not be affordable. I certainly appreciated the lone question: “do you smoke” on the insurance application after the past few decades of insurance discrimination.
If you haven’t already, check out your rates on Healthcare.gov, speak with a broker or the insurance company you are interested in using directly. Healthcare.gov obviously had a rocky start, but it’s working like a charm now.
You can easily figure out if you qualify for subsidies that will lower the total cost of your monthly premiums. Be sure to look at pharmacy and durable medical supplies associated with the plan before choosing; people with diabetes are heavy users of both.
• The American Diabetes Association has a list of ideas for you as well.
• For insurance information particular to your region click on your state on the map provided by The National Association of Medicaid Directors.
• For Medicare’s Coverage of Diabetes Supplies and Services check out Medicare.gov.
With the advent of Obamacare there’s been a decrease in approved glucometer strips per day. Many have found a limit somewhere between three and four per day. In order to buck this silly rule, it demands work from us. With prior authorization or a letter of medical necessity from a care provider plus office notes, insurance companies like Blue Cross Blue Shield will approve 10 per day. This process is similar with insulin pens.
Read the small print, it’s important to understand the benefits associated with what you pay for. Call the number on the ‘member services number’ on the back of your card, ask questions and seek help from others — your care provider usually has a person who focuses on insurance and they’re a wealth of knowledge.
Often times supplies such as glucometer strips and lancets are qualified as “Durable Medical Supplies” (DME’s) and aren’t a pharmacy covered benefit. This just means the supplies come from a mail service or perhaps another place.
If things do get processed incorrectly and you’re in dire straits for supplies, paying for a covered benefit, keep receipts and inquire about reimbursement.
File a written appeal if you still disagree about supplies not being covered. If you remain dissatisfied, contact your State Insurance Department.
Don’t have insurance?
I often hear from people who cannot afford their supplies with or without insurance. When it comes to diabetes, these supplies and medications are necessary to sustain health and life.
Many pharmaceutical companies have patient assistance programs. Look online for details or contact the company directly to see if they have one.
• NovoNordisk has a wonderful patient assistance program for those that qualify. If you do, they will send a 120 day supply of free medication to your care provider’s office and follow up refills as needed.
• Eli Lilly – According to Lilly, they’ve helped over 230,000 people last year that were uninsured or underinsured obtain their medication. They too will send medications to your care providers office.
Affordable out of pocket supplies can be found. Many people report using Reli On glucometer strips with a low price tag in the $20 range for 50 strips; they also have a line of Novolin insulins (R, N and 70/30) for under $25/ bottle and many other diabetes supplies at very affordable prices. Walmart is a distributor of this brand.
iHealth Align glucose meter is set to roll out at $16.95 (versus the previous model at $29.95) with glucometer strips dropping in cost to $12.50 per 50 strips – that’s a mere 25 cents/ strip). It plugs right into an Apple or Android smartphone to boot!
Receive Home-Delivered Diabetes Supplies
Did you know that Diabetic Connect has a program that makes it easy to find a pharmacy that can deliver your diabetes medications and supplies right to your door every month? We have a team of insurance specialists who will work directly with your insurance to make sure you’re getting the most from your coverage, and will then work with you to get the right prescription from your doctor. From there, it’s easy - your supplies come every month when needed, and there’s even a reminder when it’s time to renew your prescriptions. The customer service reps will answer your questions and can help you save money even if you have no insurance at all. Just click here, fill out the form, and we will give you a call to discuss how we can help you save money on your prescriptions and testing supplies.
Don’t settle for less than you deserve. It takes a strong backbone and an inquisitive mind, but in the end your health will thank you.