"That sounds a bit excessive..."
I recently noticed that I was starting to run low on my FreeStyle test strips.
I don't like being out of FreeStyle strips because that is the kind I use when I'm out and about.
Since I was out of refills on my prescription, I had to send a request in to my endo's office. They are usually very good about this. I can simply fax a request in for whatever I need, and ask them to write up a prescription and drop it in the mail to me. Usually within a day or two the envelope shows up in the mail, and I can then send it in to the mail order pharmacy.
I usually get a script for 900 strips over a three month supply. That is about 10 tests per day. This time however, I requested a prescription for 1100 strips (more like 12 tests per day).
A while after I faxed the request in, I got a call from one of the nurses at the office.
I missed the call, so she left a message. I can't help but to say her message put me off a little. She said she had a question on the number of strips I needed, and that it "sounds a bit excessive".
A bit excessive? Who does she think she is to judge my testing habits? She doesn't even really know me - I see her for less than five minutes every three months. That's what, 15 minutes for the whole year? A bit excessive?
Knowing that I have to play the game in order to get what I need from her (side note: interesting how these people can pretty much hold us hostage, yes?). I call back and explain that I've been testing between 12 - 15 times per day.
She sighs, then says "Okay, I'll write it, but if you need prior authorization or anything like that from the insurance, I won't be able to do it.".
Whatever. Just give me my damn script.
I just felt angry about having to jump through hoops. And what I perceived to be extra hoops. All this talk about tight control, and preventing complications, but I have to beg and plead for the test strips I need?
I know, I know. I'm actually very fortunate that I don't have to fight harder. Many of you are pressed even harder with limits being placed on you by your insurance. Or others who don't have good insurance and are limited by your budget, and are only (barely) able to buy the strips you can afford.
Don't get me wrong, I am thankful that I have decent insurance. But it pisses me off that I (we) have to fight to get the most basic of supplies.
I have just recently sent the prescription and payment in for the strips, so we'll see whether the insurance will question the amount or not. That's round two I guess.
Maybe I should freak them out and ask for what I really want!
I played basketball twice last Wednesday. Once for my lunchtime outing, then again later that evening with a friend from work. Other than putting on soggy sneakers (gross!), it was a blast. But to do what I needed in order to avoid running low or going high, I tested my blood sugar nineteen times that day!
What would they say if I asked for 1700 test strips every three months? And why the hell does she even care how many test strips I want? Does she think I'm selling them on ebay or something? Frustrating.
I don't like being out of FreeStyle strips because that is the kind I use when I'm out and about.
Since I was out of refills on my prescription, I had to send a request in to my endo's office. They are usually very good about this. I can simply fax a request in for whatever I need, and ask them to write up a prescription and drop it in the mail to me. Usually within a day or two the envelope shows up in the mail, and I can then send it in to the mail order pharmacy.
I usually get a script for 900 strips over a three month supply. That is about 10 tests per day. This time however, I requested a prescription for 1100 strips (more like 12 tests per day).
A while after I faxed the request in, I got a call from one of the nurses at the office.
I missed the call, so she left a message. I can't help but to say her message put me off a little. She said she had a question on the number of strips I needed, and that it "sounds a bit excessive".
A bit excessive? Who does she think she is to judge my testing habits? She doesn't even really know me - I see her for less than five minutes every three months. That's what, 15 minutes for the whole year? A bit excessive?
Knowing that I have to play the game in order to get what I need from her (side note: interesting how these people can pretty much hold us hostage, yes?). I call back and explain that I've been testing between 12 - 15 times per day.
She sighs, then says "Okay, I'll write it, but if you need prior authorization or anything like that from the insurance, I won't be able to do it.".
Whatever. Just give me my damn script.
I just felt angry about having to jump through hoops. And what I perceived to be extra hoops. All this talk about tight control, and preventing complications, but I have to beg and plead for the test strips I need?
I know, I know. I'm actually very fortunate that I don't have to fight harder. Many of you are pressed even harder with limits being placed on you by your insurance. Or others who don't have good insurance and are limited by your budget, and are only (barely) able to buy the strips you can afford.
Don't get me wrong, I am thankful that I have decent insurance. But it pisses me off that I (we) have to fight to get the most basic of supplies.
I have just recently sent the prescription and payment in for the strips, so we'll see whether the insurance will question the amount or not. That's round two I guess.
Maybe I should freak them out and ask for what I really want!
I played basketball twice last Wednesday. Once for my lunchtime outing, then again later that evening with a friend from work. Other than putting on soggy sneakers (gross!), it was a blast. But to do what I needed in order to avoid running low or going high, I tested my blood sugar nineteen times that day!
What would they say if I asked for 1700 test strips every three months? And why the hell does she even care how many test strips I want? Does she think I'm selling them on ebay or something? Frustrating.
posted by Scott K. Johnson | 11:23 AM
18 Comments:
Scott-
I was chuckling as I read this!
I too, have had to fight with the medical supply company that sends me my test strips. I guess they didn't believe that I was testing 10 times a day...because they decided I couldn't be trusted with a three month supply, and only will send a one month supply at a time. The person that I talk to on the phone says,
"..are you really still testing that much?"
I want to scream at them too!
I once had an endo who wrote me prescriptions for 5 strips a day. I explained that 5 strips was about a third of what I actually used, but no luck. Finally I had to bring in the Minimed literature about how oftern pumpers should check their BG (I think it said at tleast 10 times a day) and he changed his prescription, but I'm still baffled by his behavior. Why would we be encouraged to check our BG less frequently??
Glad to hear you got your prescription!!!
I get the same attitude from my CDE - aren't you being excessive??? What do they think we do with them? Do they think we LIKE doing tests? Why must they always question, misstrust, undervalue every step we take? It pisses me off too. REALLY!
It sounds like the nurse maybe didn't want to jump through her hoops either, but, you'd think that an endo's office would know how to effectively deal with insurance for the best benefit to their patients. Do you belong to an HMO? I have a suspicion that HMO's try to pressure the docs in some way to keep costs down (however, that is just a hunch - I have nothing concrete to base this on.)
This makes me recall one time when I was in the hospital and was crashing. I rang the button and told the nurse I needed to test (I didn't have my own meter with me) and she said, "oh, your chart shows that we tested you 2 hours ago - you're only scheduled for every four hours. Well, all the wrangling back and forth caused me to be so low that by the time she finally brought me the oj, I just stared at the glass and then dumped it onto the bed, resulting in a big mess to clean up........
Good luck getting that filled. I asked for that many for O and had to get some sort of override. It took SIX weeks. Pain in my ass.
I remember talking to a doctor one time about how O was high a lot during the night when I checked her. Her answer? "Stop checking her at night, then." Um, what??! That was when we switched to Joslin.
Sorry to hear that. I test from 7-15 times a day (you should have heard what the nurse last week said about that), and my insurance will ONLY pay for five times a day. And I have to get a specially-worded prescription just for that. So I buy them on the internet.
Amen man! I hate this crap!
They want us to be in perfect control but how can we do that unless we know what our BG is all day long and since no insurance is covering CGMS then we have no choice.
Dude, I feel your pain!
And dude Soggy Sneaks are gross! LOL
Been there before ... a good case of hypoglycemia unawareness will cure that really quickly. Each EMT visit costs about $700, so simple math shows that a few extra strips is far cheaper than paying for emergency service to treat a severe hypoglycemic episode.
The irony in all of this is that a) there have been clinical trials conducted in either the UK or Canada which proved that removing restrictions on testing supplies resulted in improved glycemic control and b) costs must be measured by both upfront as well as long-term savings. Unfortunately, our medical system does not operate with the long-term in mind, yet they expect patients with diabetes to do so. Irony or stupidity?
Despite the taxes, I must say that I am happy to live in a country with no restrictions on supplies (unless you live in Aarhus that is - here the local community recently decided that they wouldn't pay for more than 1800 strips a year, unless of course the diabetic could provide documentation for an increased need).
Although I can order as many strips as I wish, I still had my endo ask me if I wasn't testing too many times a day. This happened just a couple of weeks ago at my last appointment of the year, when I told him that I test at least 6-8 times a day, on "ordinary" days. On "extraordinary" days (activities and need to perform differs from other days), I will easily test twice this number of times. He looked at me like I was crazy - "4 times a day should be more than enough" almost literally written in his face, when telling me that was a lot and it shouldn't be necessary. I took his question as a measure of his ignorance about pump therapy, rather than a real reprimand, though ;-)
Anyway, I’m glad that I don’t have to battle insure about this like you do. I can just say that I hope that you win! :-)
Excessive!?! That is unreal! I hope your insurance company doesn't give you any problems. Good luck!
Hi Scott...I have just come across your page and love it!! I just started on the pump last month and am having the same issues with test strips. I am fortunate enough to have insurnace through my work and my spouse's work but still it is not enough. Now that I am on the pump, I am testing more frequently. They don't beleive I need that many strips! I can only get 100 strips at a time, which forces me to the pharmacy every week!
I truly do not understand the thinking behind limiting test strips. If anyone knows why insurnace companies do this, please shed some light. Is is as simple as a cost-savings?
:-P
I test 15 - 20 times a day. up until recently I had my prescription written for 10 times per day and the insurance filled it after prior authorization. I then paid for any additional strips I needed out of pocket. Recently I decided that was crap. I called my doctors office and told them that according to my meter, I test on average 15 times per day. When they asked why I tested that much, I told them I was hypoglycemic unaware and then asked them when would be a good time to not test, and gave them examples: should I not test before I get in the car? Should I not test before I go on a run? Should I not test before I go to sleep? Should I not test before a meal? Should I not test an hour after a meal ? When is it okay to not test when the result could be me unconscious and my two young children left to fend for themselves? When should I NOT test?
She was very positive with me after that and within five days we had an approval for 15 test strips per day.
Greg is having trouble getting more than 6/day. Since I don't use 3 every single day as prescribed, I'm starting to hoard a vial here and there for him to use, giving him an extra test or two a day.
Amen, Scott. NOTHING pisses me off more than the whole test strip mess. I'm finaly in pretty good shape test strip-wise thanks to the CGM (except for the damage to my wallet). But....
Where my blood pressure goes up is dealing with testing supplies for my patients. Most of them are T2s, but would be willing to test as often as I asked if I could get them strips.
It pratically takes an act of congress to get Medicare to pay for more than 100 strips in 90 days. Ummmmm.....how on earth do we keep any diabetic under control with one test per day?
Another small evil, there is no Patient Assistance Program for test strips. Need Lipitor, Zocor, or Viagra? Nooooooo problem! Test stips...well, no that's another story. My very poorest patients can qualify for a Patient Assistance discount of 20%. Oh great, now it's ONLY 80 cents per test.
How on earth do prices stay so high with so much "competition?" Don't answer. Rethorical Q.
We have always used 10 to 12 strips a day, usually 12. 10 on a good day. Actually, we can use more if she gets exercise or has lows, both of which are frequent occurrences. When the insurance company (same insurance) decided they wanted to cut our strips to 6 per day (and this, with a child with labile blood sugars, possibly due to just diagnosed thyroid disease), we did NOT have an ally in our Nurse CDE of 20 years experience. Her comment, when I wanted the endo to write the medical necessity on the scripts was, "10 strips a day! That's ridiculous!" Most other mothers I know use ten to 12 and in the same practice, too. So what it boils down to is they are busy and not going to bother to take the time to fight with the insurance company and/or do extra paperwork. My feeling is that it is only "ridiculous" to pay for the bare minimum in care for your child. Hunting around........ and if the nurse gives you any more flack, might I suggest you do the same?
Hey Scott,
Do you know of any blogging sites where the health insurance companies are talked about and discussed by name? I think if people used the name of their insurance company when they talk about the way they have been treated it might make everyone aware of who's good and who isn't.
Florian (Type 1, dx1967)
Proud dad of the LIVabetes Glucose Goddess
Hi Florian! Thanks for stopping by! I'm a big fan of your daughters stuff!
I don't know of any off the top of my head, but I agree - that may provide some very useful information.
One of the things that I run into occasionally is that even though the insurance company is the same, the particular policy or agreement between the employer and insurance company can vary a great deal.
You would think though that things such as customer service or timely communication would be across the board.
Thanks again!
nice post, thx
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