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# of strips allowed per insurance

Discussion in 'Parents of Children with Type 1' started by Brandi's mom, Oct 26, 2010.

  1. Brandi's mom

    Brandi's mom Approved members

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    Do you think the insurance prescription line would tell me the max number of strips it will approve per month? Right now we get 3 boxes, but I figure if the insurance will allow more why not get the Doc to up the RX...right???

    I looked at our online "price a medication" thing with Medco and it is clearly not working cuz it says 100 boxes of 100 x 3 months mail order would only be $70. I somehow doubt they would allow me to pay $70 for 30k strips.
     
  2. Beach bum

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    Medco covers our strips and we had the scrip written to "test 15x per day." So, we were getting 30 day supply 450 strips. This was because at the time, Abby was becoming more self managing with her testing and we had lots of oops! We actually had the scrip written this time for 10-12x per day because we just had way too many!

    You definitely could use more, but you don't want to have such a stockpile that you can be concerned with them expiring. It's definitely nice to have a buffer.
     
  3. Brandi's mom

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    Well I kept playing with the online thing and apparently it allows 999 boxes per month!
     
  4. Beach bum

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    Not 999 strips?
    Yikes! That's enough for Barbzzz to supply all the diabetics in Ghana!
     
  5. Sarah Maddie's Mom

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    But seriously, why would you?

    I'm all for having a bit of a stockpile of supplies for emergencies, but that's a crazy excess, imho.
     
  6. Brandi's mom

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    I would totally send about 900 to Barbzzz if I could get 999 a month!

    [​IMG]
     
  7. denise3099

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    Try it and see if you don't get a phone call. :rolleyes: If your doc writes a scrip for 15 tests a day, then you will get 15x90=1,350 for a 3 month supply for your same co-pay. But the the next time you go to fill up the system might not let you and you'll have to call and get a new script. Or you may get a call asking if you test that often. At 8-10 a day, I could refill online. At 12, it wouldn't go through and I have to have the enod call it in every 3 months. If they feel you are excessive in your orders they will start asking questions and investigate insuriance fraud, and can request logs. You can overwrite their rules to an extent, but try asking for 30 strips a day and see if they don't call you up.
     
  8. Brandi's mom

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    I am sure its a glitch in their system...I really wanted to know if I could get 5 boxes a month incase I just don't have the money to buy them when the RX refill is due, I just dont want to run out.
     
  9. Brandi's mom

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    Its not actually filling an RX for that many, I was just getting a price quote, I thought it would STOP sooner or later and say that it wouldn't cover that much, but apparently it just goes on and on.
     
  10. denise3099

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    yeah, but it will let you play with it, but even when it does cover lots of strips, then the next time you go to fill it it says it can't be filled for another month and a half! How is 90 days, 4.5 months?! With no explanation. Their computer system is wacky. it's funny that it says, you can save so many thousands by ordering from us, but it you tried it it wouldn't go through.

    I actually got scripts for a couple of different brands to try out different meters, and they sure did call me to ask what was I doing with all those strips?
     
  11. Nancy in VA

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    They don't make you go a full 90 days between refills, becuase of shipping dates, the refill might not get there before the original runs out (if its a prescription where you actually use every single dose). They let you do a refill with enough time for them to process it with insurance and then ship it.
     
  12. Jessica L

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    We get 200 every 28 days. Its not enough. I hope they will cover more which I think they will because I got them refilled on 10-4 and again on 10-25 and they didnt reject the refill. So when we go back to the pedi I am going to ask for 300 a month. I normally buy 1-2 boxes of 50 each month myself.
     
  13. kimmcannally

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    Our CVS pharmacist ran the insurance and told me the most our insurance will cover (300 strips a month). That's the amount we need, so I'm glad they will cover that much!
     
  14. sarahconnormom

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    Our insurance covers 400 strips a month for Connor. That is more than we use but I like having some cushion. Dh gets 200 a month because he just never thinks to ask for an increase. It's really never a problem though because Connor gets so many. We have a pretty good cushion right now should we need it.
     
  15. Kaylas mom

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    We get 300 a month and right now Kayla has about 200 cushion that we have hoarded over the last 6 months.
     
  16. Kalebsmom

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    Kaleb gets 300 a month. However, his endo had to write something to the insurance company so they could override it. I think they were only going to allow 150.
     
  17. Flutterby

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    we get 500 test strips per month.. they wrote it so it would be 450, but apparently the brainers at the pharmacy couldn't figure out how to do 450 so they give us 500, lol.
     
  18. KHM

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    yeah--its a definite glitch. In fact, we get a better price on our strips going through our brick and mortar pharmacy; Medco doesn't offer pricing on our brand of strips. We had to argue a good bit to get our insurance carrier to allow our Rx to go through at 10 - 12 tests per day---even after doing so, we still only receive 300 strips when we refill; we're technically entitled to 360 for our co-pay but I only have that argument when I absolutely must. Its not just our insurance---our pharmacy can be kind of surly about being in the middle of that.

    I've settled into a habit of filling my strips as soon as the 30 days are up (I never miss even a day) and I occasionally buy from seller on EBay--I'll usually buy about 400 strips at a time and I'll pay up to half of retail---so that gives me an extra 400 strips for $200--that's a lot of peace of mind for us.

    It seems to me that since L was dx'd with T1 we've had to fight for virtually everything. I do all I can to avoid any fights we don't have to have.

    :cwds:
     
  19. sarahspins

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    Okay, I am laughing at that math there... it has your retail cost at almost half a million dollars! As if!

    I get 300 a month (at only $10! It's $25 for 900 through mail order) without jumping through any hoops but I know that I could get more and it would require little more than a form filled out by my endo. I don't need more, so it hasn't been an issue, but almost all insurance companies will override the maximums for a type 1 if you present them with the proper paperwork/documentation.

    For a while I was refilling my strips (and everything else) every 23 days to get a bit ahead, and that helped me build up a bit of a stockpile. Now I just refill on payday :)
     
  20. TheFormerLantusFiend

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    Can you go to your insurance's website and find the formulary?

    For BCBS-IL, the formulary states the limits for coverage for numerous things. Such as, apparently, I have a limit of 10 syringes per day. No limit on test strips.:confused:
     

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