Anyone have a problem with insurance paying for supplies

[Kady38]

I have Blue Cross Blue Shield Indivdual policy, it says it will pay for diabetic supplies. I have a phamacy plan and 100.. ded and 80% 20% after.
A 2500 major medical deductible.
They will not consider supplies under pharmacy. Under under the major medical they will pay 80% after 2500.00 has been reached.
Had anyone else been told this? It seems unfair to me that they aren't considered with good control being a major factor in avoiding costly complications. Does anyone else think this or am I just being narrow minded on the subject.
Testing 4 to 6 times daily the cost of strips can really add up.
Getting a better plan, will cost more than I can afford now.

[jeggeman31]

I have United Health, and they also list diabetic stuff under Major Medcial. However I ony have a $200 out of pocket, and then 80/20. Then 100% after a total $500 family out of pocket is met. My son is diabetic also, so we are at 100% being covered in no time.

[Dewey]

I have United, but they have not covered Insulin pump supplies for me. I'm not sure if I'm going about it wrong or what, but will look into it further. As for the rest of the stuff (i.e. insulin, strips and other meds), they cover those items (but, at a percentage). I think a 3 month supply cost us approximately $140 or thereabouts (Not bad at all! :D).

[jeggeman31]

I have United, but they have not covered Insulin pump supplies for me.

Dewey,

I don't know if you already asked but ask them if it is covered via Durable medical. I was told no many times, until I asked about it being covered under Durable Medical, and they started saying yes. If they don't cover it under Durable medical, then I don't know any other way they would.

[middnite03]

also one other thing they "forget" to mention. I have aetna, and when I go to the drig store to buy my strips, needles( hehe not any more, thank god for the pump) and other supplies, I pay my co pay. but after an arguement over which test strips they were going to pay for, I was told they have a discount medical company they deal with named sterling medical, where I can get discounted supplies.. so instead of 20.00 a month co pay for test strips, another 20 each for lances, needles, and everything else that is not a drug, I pay 10.00 each. it's been years I have been paying the higher price, because the "forget" to mention this... so give them a call, and ask them if they deal with a medical supply company, even if the insurance wont pay for supplies, or you have a large ded., if they have this deal, you'll at least pay a better price...

end of book :)

[Middle Aged Man]

I use a mail order house for long term prescriptions, and have tried to use them for test strips. For 100 strips (10 wheels of 10 strips) for my Ascensia Breeze, they charge me $65.00, then the plan pay $15.00 and I pay the remaining $50.00.

I'm starting to look around for better deals. I have found eBay to have some good deals, but I'm a bit scared of them as the temperature exposure may be a problem if the other person didn't care for the items properly.

So . . . I'm also hunting and looking for any recommendations.

[Belinda]

I have blue cross blue shield...they pay for all my strips at 700 every 2-3 months except my co pay of 20.00. You need to call them and talk to someone. It is probably under durable supplies or something. Someone is not filing it right.

[Dewey]

Dewey,

I don't know if you already asked but ask them if it is covered via Durable medical. I was told no many times, until I asked about it being covered under Durable Medical, and they started saying yes. If they don't cover it under Durable medical, then I don't know any other way they would.

Thanks for the info. Jim! :thumbsup: I'll tell hubby and he can put that "bug in their ear" (and of course, if he can't, I always can......:- )! :D I appreciate your help! :)

also one other thing they "forget" to mention. I have aetna, and when I go to the drig store to buy my strips, needles( hehe not any more, thank god for the pump) and other supplies, I pay my co pay. but after an arguement over which test strips they were going to pay for, I was told they have a discount medical company they deal with named sterling medical, where I can get discounted supplies.. so instead of 20.00 a month co pay for test strips, another 20 each for lances, needles, and everything else that is not a drug, I pay 10.00 each. it's been years I have been paying the higher price, because the "forget" to mention this... so give them a call, and ask them if they deal with a medical supply company, even if the insurance wont pay for supplies, or you have a large ded., if they have this deal, you'll at least pay a better price...
Thanks, Paul. I'll ask them if there's one manufacturer that they deal with in particular (so I can perhaps either buy under one roof, or at least from one they'll cover). Thanks again! :thumbsup: