Insurance Companies

[TxTechKimmy]

Ok .. I must vent. First my insurance company said they won't cover my test strips for my Freestyle Flash. Fine. But now, they won't cover my cholesterol medication. This is ridiculous! You would think they would rather shell out the small amount of money (well, small to them) to cover my meds rather than pay the large amount if I go into DKA or have a heart attack. Sigh..I don't get it. Ok, I am off my insurance company soap box now. Y'all have been very therapeutic..thank you. :stupido3:

[Penny]

Ok .. I must vent. First my insurance company said they won't cover my test strips for my Freestyle Flash. Fine. But now, they won't cover my cholesterol medication. This is ridiculous! You would think they would rather shell out the small amount of money (well, small to them) to cover my meds rather than pay the large amount if I go into DKA or have a heart attack. Sigh..I don't get it. Ok, I am off my insurance company soap box now. Y'all have been very therapeutic..thank you. :stupido3:

Why would they not pay for you Cholesterol medication? Do they pay for other medications, or is it because they want you to use a generic brand? This has happened to me many times, I was on Glucophage and the insurance company would only pay for Metformin. The same with test strips, they will only pay for certain brands. For years insurance companies would not pay for birth control pills, until they figured out how much more it cost to pay for a pregnancy and another baby added to the insurance bill. You would think they could figure out it cost less to treat people who keep better control, and testing helps them do that.

[JediSkipdogg]

Ok .. I must vent. First my insurance company said they won't cover my test strips for my Freestyle Flash. Fine. But now, they won't cover my cholesterol medication. This is ridiculous! You would think they would rather shell out the small amount of money (well, small to them) to cover my meds rather than pay the large amount if I go into DKA or have a heart attack. Sigh..I don't get it. Ok, I am off my insurance company soap box now. Y'all have been very therapeutic..thank you. :stupido3:

I have to slightly disagree/comment on something. All insurance companies in most states (I think 2-3 don't have to) are required to cover diabetic testing supplies. Now, it's up to the insurance company what brand. My insurance covers One Touch Ultra strips as a Tier 2 (of 3 tiers, 3 being the highest) and covers Freestyle brand as a Tier 3. I know quite a few companies that won't cover certain brands and it's because they cost so much more than other brands. I know the manufacturer recommend price for One Touch is $80 a box of 100 and for Freestyle is $100 a box of $100. That extra $20 adds up in the long run and so some companies won't cover them. You have to find the brand you company covers.

The same applies to your cholestrol medication. If they let consumers choose any type they wanted, insurance prices would rise. That is one reason they have generics. There are some medications that are so outrageously priced insurance just won't cover them at all (many cancer drugs are this way.) You have to find the brand your insurance covers. Again, it's all about price and the drug companies wanting to mark stuff up so high.

So in the end, it's not insurance companies fault for refusing to cover certain items. It's the service provider/drug companies that won't meet reasonable prices so insurance premiums can stay as low as possible.

[poodlebone]

Ok .. I must vent. First my insurance company said they won't cover my test strips for my Freestyle Flash. Fine. But now, they won't cover my cholesterol medication. This is ridiculous! You would think they would rather shell out the small amount of money (well, small to them) to cover my meds rather than pay the large amount if I go into DKA or have a heart attack. Sigh..I don't get it. Ok, I am off my insurance company soap box now. Y'all have been very therapeutic..thank you. :stupido3:

Like others have said, find out what strips your insurance will pay for and decide which of those you'd be willing to use. Sometimes if you make enough noise and get a letter from your doctor you can convince them to cover your preferred strips.

When I was put on cholesterol meds last year my CDE wrote for something that begins with a Z. When I picked it up at the pharmacy they said it was a $50 co-pay because it wasn't on the formulary. I told them I didn't want it, called my CDE and she called in a script for Lipitor instead which is only a $25 co-pay.

You should see if you can get a copy of your insurance company's drug formulary (often the company's web site will have it) so that you'll know what prescriptions you should avoid in the future, or ask for a generic/other brand.

[TxTechKimmy]

Penny, they will pay for only One Touch strips and then only certain cholesterol meds as well. And what is weird, is it was the generic they wouldn't cover (as well as the name brand). Sigh..exactly..so they'd rather not cover the $50/month for birth control, but pay for a baby. Hmmmmm..

Hi Jedi....yeah I realize they do cover some of the supplies, it just seems they aren't covering any of them my doctor prescribes. It'll all work out, but it is just taking time and I'd like to get started on the cholesterol meds ASAP. Ok..then I'm getting off my insurance company soapbox and getting on the pharmaceutical company soapbox! :)

Liz..I didn't think about that. Good idea. I suppose it would be a lot easier if I could take a list in hand to the doctor and let them pick.

[Dewey]

I have to slightly disagree/comment on something. All insurance companies in most states (I think 2-3 don't have to) are required to cover diabetic testing supplies. Now, it's up to the insurance company what brand. My insurance covers One Touch Ultra strips as a Tier 2 (of 3 tiers, 3 being the highest) and covers Freestyle brand as a Tier 3. I know quite a few companies that won't cover certain brands and it's because they cost so much more than other brands. I know the manufacturer recommend price for One Touch is $80 a box of 100 and for Freestyle is $100 a box of $100. That extra $20 adds up in the long run and so some companies won't cover them. You have to find the brand you company covers.
This is odd, because my insurance charges me more of a co-pay for One Touch strips than it does Freestyle Flash ones. Also, at Wal-Mart & Target (both here & in the Seattle area), Freestyle strips are actually cheaper than One Touch....I'm not trying to knock One Touch, but that was one of the reasons I switched a while back.....of course, with the latest issues in software & download capabilities, I'm back to One Touch. :D

Penny, they will pay for only One Touch strips and then only certain cholesterol meds as well. And what is weird, is it was the generic they wouldn't cover (as well as the name brand). Sigh..exactly..so they'd rather not cover the $50/month for birth control, but pay for a baby. Hmmmmm..

Hi Jedi....yeah I realize they do cover some of the supplies, it just seems they aren't covering any of them my doctor prescribes. It'll all work out, but it is just taking time and I'd like to get started on the cholesterol meds ASAP. Ok..then I'm getting off my insurance company soapbox and getting on the pharmaceutical company soapbox! :)

Liz..I didn't think about that. Good idea. I suppose it would be a lot easier if I could take a list in hand to the doctor and let them pick.
I feel ya, Kim. Insurance sometimes ticks me off as well....As we All know, they (like any other big company) are in it to make profits & shell out as little money as possible. Although they've become somewhat better over time, they still have a ways to go, and some companies are still trying to "buck the system" of prevention over cure. Feel free to vent anytime. We'll do our best to help, and if nothing else, provide an ear & support.

[JediSkipdogg]

This is odd, because my insurance charges me more of a co-pay for One Touch strips than it does Freestyle Flash ones. Also, at Wal-Mart & Target (both here & in the Seattle area), Freestyle strips are actually cheaper than One Touch....I'm not trying to knock One Touch, but that was one of the reasons I switched a while back.....of course, with the latest issues in software & download capabilities, I'm back to One Touch. :D

I was using my insurance and the prices they have listed on their site. I guess it's just a mystery with how much each company is willing to sell to their insurance company for.

[Dewey]

I was using my insurance and the prices they have listed on their site. I guess it's just a mystery with how much each company is willing to sell to their insurance company for.
Now that you mention it, I've noticed this issue with infusion sets & cartridges as well....Some companies will sell sets/cartridges to the insurance companies & end users (who pay the co-pays) for a way jacked up price, while others will sell for a little above consumer retail....at any rate, it's all quite expensive. :(

[Ronin]

The problem with medical insurance companies is that they have all morphed into stock companies when they used to be "Mutual" companies. Worse yet, many employers are "self insured" because they found out how profitable these businesses can be.

A mutual company understands that the participants are "mutually indemnifying" each other. The idea is that we all put our money into a pool and those with needs draw on the pool. Not everyone draws at the same rate and the larger the base the better the benefits. Preventative care is encouraged because it prevents more expensive emergencies.

Stock companies don't get it. They look to the next month/quarter/year end and figure the less they put out in benefits the better the stock will do in the marketplace. Their ideal would be all preimums and no payments.

Assuming you are an American (not completly sure on this list) complain to your elected representatives in Congress as well as your state. Also see where their biggest source of campain funds come from (probably insurace companies). Scream like a banshee!

[rzrbks]

I had to do the same thing.

New Ins Co. and had to wait until they covered the strips for my InDuo. Took about 4 months but then I was back to the One Touch which my InDuo uses.



Ronin

Scream like a banshee!

That works in Blue states, but in Red states, like mine, it's a version of the 50s all over again:

Duck and Cover(a particular part of your anatomy).

[TxTechKimmy]

It is just such a hassle when you need the strips now, but have to deal with your doctor calling in something else, getting a new monitor, etc.

Dewey...I'll check Target out to see if the Freestyle strips are cheaper here in Dallas like they are in Seattle. That's good to know. If not, I'll send you some money to get them for me. :) j/k