Blue Cross/Blue Shield is trying to kill me.
Ok, that might be an overstatement. But i have been trying to get a refill for my test strip prescription for 3 weeks and I'm not getting anywhere. When I requested the refill, it was not expired or out of refills, but the insurance company still denied it and wanted all the documentation to verify need. My doctor had originally requested 10 strips/day, but BCBS would only fill 200 every 20 days. Now this same request has been in review for 3 weeks and I'm told it may take another week before it is approved. How do you handle problems with insurance? I've been fighting with them for 30 years and it is always a battle. I just filed a complaint with the state insurance commission, but I don't know if that will help any.
Replies to This Discussion
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Permalink Reply by BMD on -
It's unfortunate that the fraudulent actions carried out by many D patients has caused many insurers to tightly control the approval of medications and medical supplies. It used to not be this way, but online-based gray markets demonstrate the current problem. For example, I just logged onto Ebay and did a search for test strips under the diabetic aids subcategory. There were nearly 2,000 hits for test strips on sale. Many of those test strips come from the stockpiles of current diabetic who chose to make a little money by selling their overage. The end result of such practices is that insurers now have to carefully screen and approve each rx to control costs and prevent further fraud.
It's patients like you who need the test strips and who want to use them as intended who are the victims of the fraud. The bottom line is that although the insurers often seem like the bad guys, often they are not. Sorry that you are having to suffer because of the selfishness and greed of others. I can definitely relate.
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Permalink Reply by Stuart on -
Hello Elaine:
Ten strips a day will never fly... its a concrete bird (for them). Medical necessity (ie the minimal side) will be their approach.
You're not saying you haven't used/gotten any strips for three weeks are you
8 0 ?!
If you want more strips and they won't pay try getting the off-brand strips at Walmart, Target, Kmart, etc. Their prices for their generic brand strips are definately less... you're out of pocket cost will be less if you stick with 10 strips/day idea.
Stuart
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Permalink Reply by Elaine on -
I have friends who loaned me strips after I ran out. Thank goodness for friends!
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Permalink Reply by Marie B on -
hi Elaine, sorry you are experiencing such frustration! I've been there, and the problem was with my PCP doctor. He was not responding to BC/BS with the right letter of medical necessity. So I changed and had my endo write the Rx, and he does everything electronically. We have Anthem BC/BS of California and I use the Express Scrips mail order service for my strips and Insulin. I see you are a type 1 on a pump like me. My endo writes these instructions on the Rx "test 8 to 10 times a day". Since I changed, I haven't had any problem at all.
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Permalink Reply by Elaine on
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On the way to the pharmacy. BCBS says it has been approved and should be ready. Was it my multiple phone calls, blog post, Facebook post, complaint filed with insurance commission, email to ou benefits, or mention of a lawyer that got it done. At this point I don't care as long as it's ready. They approved 300/month but I have to buy them 200 every 20 days, which is what I was doing previously
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Permalink Reply by Kelly WPA on -
Did you mean 200 strips every 30 days? 200 every 20 days actually works out to the 10 per day so I am guessing the 20 was a typo.
I agree with BMD - there are so many people getting strips then selling them on eBay, it is making it hard for those of us that need them & actually use them. More insurance companies are cutting back on the number of strips allowed & we have to take extra steps to get them. I just keep doing the appeals to get what I need - we don't have much choice.
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