[Signmom99]

I get an rx for test strips from the doctor but he keeps insisting that the insurance will only pay for once a day to test. I'm t2 non-insulin depend. controlled w/meds only. But tonight when I went to walgreens to fill my test strip rx the pharmacist had put a note on the rx to ask how many times a day i test. They said that if the doctor would write the rx differently or do a pre-auth that the insurance would test for more. She said all he has to do is state that I test more frequently in order to maintain my levels so that i don't develop the need for insulin.

Does anyone else have any experience with this?

[RikBrooks]

Every insurance is different. No insurance will pay for what your doctor didn't order though.

I would just tell my doctor to order me more and let me worry about the insurance.

[fgummett]

Your Doctor should be pleased that you are being proactive and taking charge of your D. He should also realise that you are testing for YOU not just for him... the once a day test only serves to give him a rough (very rough) idea of how your BS has been over the weeks or months between visits... the ONLY way to take control of your D and really find out how you react to different meals is to test. Sounds like your Pharmacist is more switched on that your Doctor. Good Luck

[BrianSCohen]

Almost universally, diabetic supplies like test strips are covered when your doctor prescribes these in the US. If your doctor is not helpful getting appropriate test strips, he may not be the right doctor for you in the long-term. You can always ask for your insurance company directly if it will be covered, but my bet would be that if you have a common insurance company your pharmacist will know right off the top of his head about coverage.

I am type 2, testing three times a day. If I got pushback from my doctor, my pharmacist or my insurance company about my testing, I would make them wish they had never gotten out of bed that morning.

[JediSkipdogg]

You should worry about your insurance and your doctor should would about your health, the two shouldn't worry about each other. Doctors many times are a checks and balance type system for insurance companies however, some refuse to do any budging. I'd tell your doctor to write the script out for 2-3 times a day (most insurance companies now want the scripts to state how often to use it) and if your insurance refuses then we can help you on that one. If your doctor won't budge, then maybe it's time for a new one.

[Signmom99]

I know it's kind of anal, but I test before and after each meal and usually in the morning first thing. My diet varies so much and since it is just me and dh now, I try to keep things as simple as i can. What we cook usually accommodates both of us at the same time.

But I will try as you all suggest. IS his way of thinking "the ins will only pay for 1x daily if not on insulin" the old school way of thinking?

Then that brings me to the ??? that if he is not willing to accommodate my wishes, at what point is going to an endo a wise choice? My #'s are not bad and definitely not up at the 126 level. I am still IR but only cause i'm diet & med controlled.

[princesslinda]

My doc originally wrote my Rx for 1 test/day. I asked for the maximum my insurance would allow for a non-insulin dependent diabetic (which is 4 times a day) and he wrote it for that. I now get 100 strips every 25 days.

My doc didn't see the need initially, but when he say my much improved A1C 3 months after diagnosis, he was willing to write the extra strips.

[Jill-O]

My insurance has always covered my test strips. I used to test 3x a day, I think... now I test 6-8x a day.

Good luck!

[fgummett]

Originally Posted by Signmom99

I know it's kind of anal, but I test before and after each meal and usually in the morning first thing. My diet varies so much and since it is just me and dh now, I try to keep things as simple as i can. What we cook usually accommodates both of us at the same time.

But I will try as you all suggest. IS his way of thinking "the ins will only pay for 1x daily if not on insulin" the old school way of thinking?

Then that brings me to the ??? that if he is not willing to accommodate my wishes, at what point is going to an endo a wise choice? My #'s are not bad and definitely not up at the 126 level. I am still IR but only cause i'm diet & med controlled.

Not anal at all! Testing is the only way we can take control of our D. Don't ever be apologetic for trying to keep yourself healthy

As for his attitude: might be "old school", might be as a result of the perception that the majority of those with D are not as proactive in their self-care as most here on DF are, could also be that some Doctors feel threatened when the "patient" starts taking control of the diagnosis and treatment

Great that your numbers are not bad That is even MORE reason to test now... so that you can work to KEEP them that way.

I'd try talking to your Doctor first... if he does not seem willing to budge or open to your input then he probably won't go for an Endo anyway (assuming you need a referral as we do in Canada?)... might be time to change.

[TomB]

Y'all better take a deep breath and take a real good look at what's happening with medical coverage. Folks, the QUALITY just keeps getting worse because the bean counters run the show, not the doctors.
For Type II diabetics, Medicare allows 50 test strips per 90 days. Same for the VA, 50 strips for 90 days. BCBS is slowly changing policies to 50 strips for 30 days. They justified this on a study done in the UK of about 500 diabetics who did just fine with hardly any self testing. Unfortunately, there doesn't seem to be any study to back up what we all know makes perfect common sense.
I truly really, really wish that all bean counters were Type II diabetics! Add in a few congressmen and a few big wigs and we'd get the test strips we need.

[fgummett]

Not just the bean-counters... we need to ADA/CDA/NHS etc... to smarten up and realise that home testing can lead to better control and fewer complications

[pegasus]

It may also be that the doc doesn't want to be bothered by the insurance company for a justification for the number of tests. But that's part of his job. If he won't give you an Rx for what you find helps you keep good numbers, find a new doc--and it should be a new endo. My bro went to a very nice GP for way too long when he was dx'd as T2 ...

[cyberus]

Originally Posted by TomB

Y'all better take a deep breath and take a real good look at what's happening with medical coverage. Folks, the QUALITY just keeps getting worse because the bean counters run the show, not the doctors.
For Type II diabetics, Medicare allows 50 test strips per 90 days. Same for the VA, 50 strips for 90 days. BCBS is slowly changing policies to 50 strips for 30 days. They justified this on a study done in the UK of about 500 diabetics who did just fine with hardly any self testing. Unfortunately, there doesn't seem to be any study to back up what we all know makes perfect common sense.
I truly really, really wish that all bean counters were Type II diabetics! Add in a few congressmen and a few big wigs and we'd get the test strips we need.

Problem is, congresscritters and bigwigs have the type of insurance that DOESN'T have those kind of limits because they have the US Treasury is paying the bills, whatever THEIR docs say they need they get.

[owlyn]

It may be that he is being pressured by the insurance company. Some doctors cave in to the pressure, others don't. It could be time to shop for a new doctor.

[BrianSCohen]

Originally Posted by owlyn

It may be that he is being pressured by the insurance company. Some doctors cave in to the pressure, others don't. It could be time to shop for a new doctor.

Wow, Stop right there. If this has occured, I would report that doctor right now and report the insurance company. That is not legal.

I just looked it up. In CA your diabetic supplies are totally covered. Here is a summary of the provisions:

Requirement related to diabetes? Yes
Diabetes Education services covered? Yes
Medical nutritional therapy covered? Yes
Diabetes supplies covered? Yes
Specified supplies covered? Yes

More detail can be found at IsletsofHope (IOH - State Diabetes Related Laws - California).

In this situation, I would just confront my doctor, I would not even ask my insurance. If he is making up lame excuses to keep his patients from self-monitoring their own blood sugar levels, then he is acting in an incompetent manner. This is definitely not the type of doctor that you want to advise you on your diabetes. If you lived near me, I would personally volunteer to come by and slap your doctor upside his head.