Test Strip Insurance coverage

[TomB]

Had to change insurance to Blue Cross Blue Shield for NC state employees. Test strip coverage went from whatever I wanted to 50 per month for Type 2 diabetics. Type 1's get 150 a month. After several fruitless phone calls I was told to be thankful because Medicare only allows 30 per month for Type 2's. In addition, they consider insulin to be a premier drug so that makes its co-pay 3 times more than generics.

They wouldn't tell me how frequently to test so I guess I'll do a good job of testing on Sundays and Wednesdays and save the remainder for when I feel weird. I guess if I feel weird too often I'll go to an ER and let BCBS pay for that.

Looks to me like insurance companies are micro managing health care to save a few pennies which results in being most unfriendly to diabetics.

Anyone have any ideas for where and how I can get a few more test strips a month without them costing me an arm and a leg?

Tom

[palefacegirl03]

That really sucks.
I think I would want to see the restrictions on test strips for either type in writing.

I have Athem BCBS of Va and have not problem with my test strips(knock on wood, that I did not jink myself) I just got 900 strips, so that I can test 10x a day for 90 days, and my copay was 100 which is my 20% on DME

[Handybear]

I also have blue cross and blue shield. They originally said only 50 strips a month, so I went back to my doctor and told him I needed to test at least 4 times a day and he wrote me a new prescription and my insurance has been no trouble since. I get 200 strips every 50 days. Maybe your doctor could do the same for you.

[kgm0612]

Tom...........do as Handybear did and have your doc write you a script for more strips.

Karen

[xMenace]

Move to Canada, eh ;) My Blue Cross limits me to a three month supply every visit. "So I can come back in tomorrow and claim another three month supply?" "Yes." "How many strips in a three month supply?" "It doesn't say." "OK" :D

[pdxdennisj]

I'm a type 2 and I get 90 per month covered by Medicare. The doc wrote a script justifying it.

[pdxdennisj]

P.S. Deals can be found on Ebay.

[TomB]

I though my doc had send in a justification for more test strips but perhaps he didn't. I'll call and find out. Tried to find the form for this on the BCBS web site but no luck even though BCBS says you must use their form.
With North Carolina being quite a bit above the national average for diabetes, you'd think that BCBS would be more cooperative in their part to keep glucose under control. But then, maybe that's why NC is above the average.

[princesslinda]

At diagnosis with an A1C of 9.6, I was told to check once a day, fasting only. I had a family member who is T2 and only checks maybe once a week, "donate" some strips to me. When I returned to the doctor for my next A1C, it was down significantly. I told the doctor i'd been testing 4-5 times a day, and he said "keep doing what you're doing, it's obviously working" and wrote me a prescription for 100 strips/25 days. That's the maximum my insurance will cover for someone not on insulin.

If you can't get your strips covered by your insurance...i'd suggest getting one of the "generic" meters at Walmart...the strips are much less expensive...you could use these for "backup."

[Alice]

Also, check your state laws regarding diabetic supplies. Most insurance companies will "stretch" their maximums when a doctor's letter is sent.

[notme]

What type of meter are you using Tom?

[Fenway]

I'm on Medicare, and get 200 strips every 3 months. My doctor wrote a note that I needed to test twice/day. I'm T2, not on insulin, but they prescribe what he wrote.

I have to supply them with a 30 day record of test results every 6 months - but I do get the strips.

[EdnBama]

I'm a state employee in Alabama and diagnosed as type 2. Blue Cross Blue Shield administers our insurance program although our State Employees Insurance Board actually determines the coverage policies. (I don't think I knew who determined the coverage in policies when I was a North Carolina state employee, but I wasn't diagnosed as a diabetic back then either.)

Under my plan in Alabama, I'm able to get whatever quantity of test strips my doctor prescribes for one set copay. I usually get 100/month. I've had lower and higher quantities in the past.

Although I know that insurance companies want to minimize costs, I can't imagine an insurance actually believing that it's reasonable to ask a diabetic (even if "only" type 2) to test only once a day.

I would definitely ask the doctor to write a prescription for what you realistically need and then pressure BCBS up there to cover it.

[EdnBama]

I got curious and did some hunting. Here's the web page on the NC State Health Plan site that says they cover only 150 strips per 3 month period for Type 2 diabetics:

Diabetic Testing (http://www.shpnc.org/pharm-diabetic-testing.html)

There's a statement that says "If you use larger quantities, you may obtain additional testing strips under your medical benefit, as before", but I couldn't really tell what that means, unless it means that it falls under your normal major medical deductible.