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Insurance companies who don't follow prescriptions
by cedarwolfApril 4, 2009 5:39 PM
8 Replies
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| From | Replies |
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sparkysmom |
sparkysmom replied April 4, 2009 6:53 PM
Yea my insurance only allows me 100 strips a month. Pretty bad when Dr wants me to test 5-6 times a day. They are at the high end of my pharmacy too. Better than no insurance but I sure would like to know why the limit. also they sent me the monitor they want me to use. If I use the one I like I have to pay for strips.
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Judimar |
Judimar replied April 4, 2009 8:58 PM
I had my insurance company send me a monitor they "sanction" but the cost of the strips were not much different. Now we had to change insurance providers due to the company my husband is now employed has changed. He is a government contractor and the company who bought the contract he is working on changed.
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Desdemona |
Desdemona replied April 13, 2009 8:14 PM
Yeah- I had to change insulins to avoid a $100 copay. They also are providing OneTouch strips for free, but Freestyle strips have the $100 copay. Since I use an Omnipod, it's aggravating to have to carry 2 meters. |
kdroberts |
kdroberts replied April 13, 2009 9:01 PM
hat's how health insurance works. The insurance company decides what and who they cover. The customer (in your case your employer) decides what they will pay and the insurance company comes up with policies for them. If you want to see what's covered you need to check your insurers formulary. The two most covered testing supplies are accu-chek and one touch. Unfortunately you have to go with what your insurance says. Depending on who is making the decision to not cover the strips, the insurance company or your employer, you may be able to get it covered and at a higher rate. I know that my insurance company will only cover 200 strips a month but with prior authorization they will cover what the doctor says. However, you need to prove a reason why, insulin use is a good one. However, if your employer is deciding the coverage, you have no options. |
roger |
roger replied April 14, 2009 1:13 AM
yes!!!!!!!!!!!!!!!!!
kdroberts replied April 14, 2009 12:35 PM Are you sure they are giving you 150 per 30 days or for another amount? My prescription is for 6 times a day which would be 180 per 30 days. Since test strips don't come in boxes of 180 the pharmacy runs it as 100 for a 15 day supply. That way I actually make out in the long run by getting 200 strips per month rather than 180. Could it be that something similar is happening to you? Just ask your pharmacy and see how many days supply you are getting. If you really are getting short changed, ask your doctor to submit a prior authorization application to your insurance company, that way you should be able to get 200 per month.
roger replied April 19, 2009 2:39 PM the dr was very upset the last time i pointed this out to her she is looking in to it for me but told me it happens a lot that is all they will pay for |
Mom and boys |
Mom and boys replied April 14, 2009 4:49 PM
LORD .... time for me to follow through. I have been paying for my strips because I did not think insurance paid for them! I will be doing some resarch :) |
I have a state medical insurance policy because I teach. Our state insurer has decided that it doesn't matter what the doctor writes for diabetes prescriptions and equipment, they only like the two most expensive readers and strip products, and they, not the doctor, will decide how many strips you can have per month. The co-pay is almost as much as an outright purchase. Anyone else having problems such as these?