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insurance not covering our test strips!

Discussion in 'Parents of Children with Type 1' started by ChaosRules, Sep 11, 2013.

  1. ChaosRules

    ChaosRules Approved members

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    We got a letter from our insurance letting us know that as of October 1, they will no longer cover any test strips except for Freestyle made by Abbott. :mad: Of course, the Freestyle meter doesn't communicate with a Minimed pump.

    We have to get his doctor to write a letter explaining why the "Abbott Diabetes Care preferred test strips" won't meet his needs, and why the brand we're requesting is medically necessary. Then, if we're lucky, they'll approve his test strips. Grrr.
     
  2. ksartain

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    BCBS? Even if your doctor writes the note, you'll have to pay a 20% co-insurance. :(

    We switched to Contour Next and now only pay $15 per month for our strips. We ended up saving money.

    You can also go through their diabetes distributor, Edgepark, and pay $5.25 per box of 50 regardless of the brand. I spoke with them yesterday about it. That probably depends on your policy, though. It would be worth it to call them. Look up Edgepark Diabetes Supplies.
     
  3. missmakaliasmomma

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    My daugher's insurance has approved 2 things that they technically don't without a letter of necessity. One touch strips and apidra. We didn't have an issue at all, I'm hoping yours goes as smooth.
     
  4. Traci

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    We got the same notice. I was prepared to go to war. Endo sent a letter of necessity and we got a LIFETIME exception letter. Yes, you read it right. They approved the strips that go with his pump for life. I don't have to fight them every year! Hoping yours goes as smoothly!
     
  5. MEVsmom

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    BCBS plans are not all the same just because it's BCBS. It depends on your employer and their program in what they cover.
     
  6. danismom79

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    These things happen, and once your endo sends the statement you'll likely get the strips covered. You may have to pay a higher price. My insurance covered my daughter's pump with no problem, but then it stopped covering the strips that go with it. The endo sent a statement and I have to pay at the highest tier ($50 instead of $30), but it wasn't a problem.

    Hopefully everything goes smoothly for you. We do have to fight sometimes, but try not to get riled up unless you actually have to (that's my tidbit for everyone, not just the OP).
     
  7. ksartain

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    This is definitely true. We have our kids on their own policies, but will be switching to our employer insurance because of the deductibles and better coverage. Their own policies were fine until his diagnosis. :(
     
  8. caspi

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    This is incorrect. Not all BCBS plans are the same. We don't pay anything out of pocket for our strips. They did try to limit us to 200 a month (instead of 300) but our endo's office put a stop to that. ;)
     
  9. momof2marchboys

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    we pay the highest co-pay for the Contour test strips b/c they are not the preferred brand for DS insurance but we also have the Contour Choice copay assistance card that applies $35 towards our copay which helps make them more reasonably priced
     
  10. ksartain

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    You're right. I forget how many different types of policies they offer.
     
  11. Megnyc

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  12. ChaosRules

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    Oooh, I hope it works that way for us! What insurance do you have? We have Health Alliance (in IL).
     
  13. Sarah Maddie's Mom

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    Smartest thing I've read on CWD all month. :cool:
     
  14. ChaosRules

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    Yeah, we got that card too, so we've only been paying $15/mo for the Contour. I think that ends at the end of 2013, though.

    We had been using the OneTouch, and our copay for those is also $50.
     
  15. ChaosRules

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    I went to the link, and I wish I'd known about this a long time ago! Unfortunately, it looks like it will be ending in December. Too bad - it's a fantastic deal.
     
  16. Jordansmom

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    Most of these programs have a published expiration date, but often get renewed. The Apidra savings program has been renewed every year right before expiration. We just have to sign up for a new card.
     
  17. ChaosRules

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    OK, I'll try it then!

    My son's endocrinologist has refused to write a letter to the insurance company. This is the reply I got when I asked them to write one:

    I am writing to inform you that we have not had any luck with this with Health Alliance. The main thing stated in the letters to patient's is we need to prove that a certain strip is "medically necessary" which we cannot. They are denying appeals by stating, "any meter can be used with any pump, as all pumps allow for manual entry of the blood sugars." We have already had many denials with this statement on the denial letter. At this time we have not been sending letters for this type of situation, as it has not gotten any approvals.

    I tried calling the insurance company directly, and all they told me was that his doctor should send a letter, and their medical team will review it. Maybe I'll have his PCP write one. I mostly just feel like giving up.

    What an insult to not let him use the test strips that communicate with the meter, although I suppose I should be glad they approved the meter (and the G4!) in the first place! In the end, those are more important.
     

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