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Insurance disallowing Freestyle strips for Omnipod user

Discussion in 'Parents of Children with Type 1' started by Snowflake, Mar 7, 2016.

  1. Snowflake

    Snowflake Approved members

    Joined:
    Dec 1, 2013
    Messages:
    482
    Help! We got a notice from our insurer (Anthem BCBS Colorado) that it will no longer cover Freestyle testing strips for our daughter, who uses Omnipod. The notice says that the strips aren't medically necessary and that other strips work just as well.

    We're irritated about the hassle factor of having to use a separate meter, of course, but we're particularly worried about safety with so many other caregivers taking care of our daughter. For example, in order for our daughter to have a full summer of care, we've had to enroll her in four different day camps, each with multiple staff who will handle pokes etc. I shudder at the possibility for user error by a bunch of counselors new to diabetes having to learn two different devices and then do manual entry of numbers.

    Has anyone successfully appealed a determination that integrated meter strips aren't medically necessary? Is our daughter's age and reliance on non-parent caregivers a relevant consideration?
     
  2. Beach bum

    Beach bum Approved members

    Joined:
    Nov 17, 2005
    Messages:
    11,315
    We encountered a similar issue with the Revel/Contour meter. Our doctor had to write an appeal stating that the pump works with the meter, sending important data and that it is to be covered for an entire year. I would call your insurance and ask them what the exact wording is that they want to see on the appeal so that they can approve this. I do recall that I had to get the phrasing from the medical side and not the pharmacy side (where they told me they would cover 2 new pumps in order for us to have strips that work with a meter covered!).
     
  3. Cheetah-cub

    Cheetah-cub Approved members

    Joined:
    Feb 18, 2014
    Messages:
    241
    We also encountered this issue a few months ago. Our insurance sent us a letter that they dropped the Freestyle, and wanted us to use a different test strip. Our endo wrote an insurance override note for us, explaining that our pump only works with Freestyle. We were able to continued to get our Freestyle test strips from our insurance as before. It was pretty easy, no hassles.
     

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