[butterflykisses]

Originally Posted by jer.lawrence

This brings a question to mind -- I talked to my insurance company before going to the doc earlier this month. The insurance company covers 200 strips per month. I told the doc this, he said I shouldn't need that many, but wrote the prescription for the 200 anyway.

The PHARMACIST asked me how often I tested because she didn't think that I needed 200 a month, and because the insurance company didn't like paying for that many.

I ended up telling her that I usually test 3-4 times a day, but there are days when I need more. They only filled me for 100 of the 200 that the doc wrote.

That's 100 for 25 days, which is 4x a day. I would get all up in arms about it, and I half way still feel like I should, but I actually DO usually only test 4x a day -- it's more than that on weekends though.

100 aren't going to last me 25 days, I don't think. I guess I'll talk to the pharmacist next time.

If the pharmacist didn't fill your prescription as written then you should go back and get the rest of them. It's not up to them how many you use!!! It's one thing if your insurance company won't pay for that many...although they could still fill it with you paying the difference...but its not up to the pharmacist.

[butterflykisses]

Originally Posted by sarahspins

Ha.. and here my CDE asked me on Thursday "are you sure 300 is enough? I can write it for more if you want me to" after I mentioned that my RX was going to run out before I saw my Endo again in two weeks, and I said 300 was just fine since that's all insurance will cover without a pre-auth, and I really wasn't sure I wanted to go through the hassle when I didn't have a problem with what I was getting

She did mention that insurance HAS to pay for however many strips are prescribed if it says on the RX to test before driving, especially for anyone who is hypo-unaware (and yes, I always test before getting in the car). I didn't think to ask how many more per day she would suggest, since I seem to do fine with 10X a day.. some days are less, some more, but overall, it seems to work out.

Sorry you had to deal with bean counters, but I'm glad you got your strips in the end

Thanks Sarah, I'm glad I got the strips worked out too!!!

My doctors PA acted like it was inconvenience for her to have to write letters to justify "extra" strips. I'm not sure at what point they become "extra", but I wasn't asking for more than normal or more than what my insurance pays for. I don't always test 10 times, sometimes it might be 8, sometimes 14, and like you, it all just works out. I've been getting 300 strips for a long time now and the prescriptions have been coming from THEIR office. That is why its so perplexing as to why all of a sudden she's giving me all this resistance? I'm just frustrated with them and not sure I want to go back, especially with the negative feelings I have about them right now. You're lucky to have people who understand the need for test strips.

[sarahspins]

Originally Posted by butterflykisses

That is why its so perplexing as to why all of a sudden she's giving me all this resistance?

I really do wonder if some insurance companies aren't sending out form letters to physicians suggesting that they limit their patient's use of strips.. it really does seem like there have been a LOT of people complaining of this lately.. it does make one wonder.

Of course, my insurance sent me a letter last week, suggesting I switch from Apidra to a "less expensive" option to save ME money. As if they don't have in their records that I was ON the insulin they suggested? It's stupid...

[khewell]

My insurance co pays for 100 strips a month. Doc says I need 175. What are you to do??? Looks like the insurance co would be happy to pay for a few extra strips a month and maybe prevent complications and more expensive cost down the road. Keeps us happy and puts more money in their pockets down the road since thats all their looking at anyway.

[Josselyn]

Originally Posted by jer.lawrence

The PHARMACIST asked me how often I tested because she didn't think that I needed 200 a month, and because the insurance company didn't like paying for that many.

I ended up telling her that I usually test 3-4 times a day, but there are days when I need more. They only filled me for 100 of the 200 that the doc wrote.

That's 100 for 25 days, which is 4x a day. I would get all up in arms about it, and I half way still feel like I should, but I actually DO usually only test 4x a day -- it's more than that on weekends though.

100 aren't going to last me 25 days, I don't think. I guess I'll talk to the pharmacist next time.

SHE didn't think you needed 200 strips???
I'm unsure why the pharmacist feels it's her business to step between what you and your doc have agreed is the appropriate number of strips to have. Is it even legal to interfere in the quantity of any med or supply that your doctor deems appropriate? I'm pretty low key, but I'd have been insistent on the prescription being filled as written with no interference from her. You'll now have to go back for what should have been yours in the first place (nuisance) and pay another co-pay to do it. Someone's benefitting from this, and it isn't you.

I had a doc who told me to test AM and PM...and before and after each meal (I count SEVEN tests per day there)...and then wrote a script for 100 strips...

I've discovered strips on eBay for not much more than my co-pay is in the first place...thank goodness.

Not everyone got A's in medical school.

[foxl]

Josselyn, those strips most likely WERE on EBay because someone else was buying them up and re-selling them, and THAT was why the pharmacist was intervening (which obviously defeats their purpose in doing so ... DUH).

I would have said I tested 10 times/ day and then you'd've gotten the full supply.

That is clearly not the way to restrict the black market though ... wonder if this was Pharma propaganda on how to cut it back?

[butterflykisses]

I know that a lot people are getting their extra needed strips through Ebay and I hope I don't offend anyone...but they need to address the issue of those committing fraud, selling test strips paid for by the government or private insurance and stop trying to ration them to those who need them! It shouldn't be that hard to track down where the strips are coming from. They could ban the sale of them "through authorized dealers only". Put a stop to it like they did pump supplies. If the government and insurance companies were not losing money over test strips fraud they might be less restrictive for those who don't abuse them.