insurance monitoring
Does anyone else ever get a call from their insurance company if they are late ordering a med and they think you are not taking it? My internist office called today saying my insurance (secondary since I am on Medicare) called them to say I was not taking my (specific med)! Well, I am taking it and was a bit late in sending a new script for more but I try to build up extra meds and had enough to last me. I had gone beyond my 90 day supply in reordering.
This has happened to me once before with a different med--same issue, last year.
I think it is strange. It had never happened with me before last year so I wonder if this is a new policy with insurance companies that they keep track of your med orders and "tell on you" to your MD. And I certainly have been late a few times over the years though it is only a very occasional thing. And, as noted, I build up a supply by ordering a bit early each time. I do not like to run out. My secondary is BCBS. It feels a little like Big Brother is monitoring my med intake.
Could it have anything to do with my being on a pump? Or just Big Brother.
This has happened to me once before with a different med--same issue, last year.
I think it is strange. It had never happened with me before last year so I wonder if this is a new policy with insurance companies that they keep track of your med orders and "tell on you" to your MD. And I certainly have been late a few times over the years though it is only a very occasional thing. And, as noted, I build up a supply by ordering a bit early each time. I do not like to run out. My secondary is BCBS. It feels a little like Big Brother is monitoring my med intake.
Could it have anything to do with my being on a pump? Or just Big Brother.
Replies to This Discussion
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Permalink Reply by Laura S. on
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Yeah, I had the nurse thing too.
A caseworker nurse who swore she could get me a new pump (my copay is really high).
She didnt do anything, I had to send financials.
Thank God my new pump is supposedly on order, but I dont know if I have heard the last of her.
She insisted they only cover pumps when yours is broken (not true).
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Permalink Reply by Chadd on -
I had posted on another part of the vast amount of meds and supplies I have for diabetic supplies and other medical related issues. I'm well stocked on supplies for over 4 months to over a year on alot of my supplies. I'm very much afraid of losing my job and my insurance that I tend to keep a stock of supplies. I have lost my job before and having to fight with the system to get on assitance or supplies / medications it was a mess. So I thought I will not be placed in a position like that again, so I started to stock up on supplies.
I had talked with my pharmacy to find out when exactly I would be able to order supplies / medications and just made comments on the calendar, had setup up a reminder in outlook, along with what med to order, perscription number and when I would pick it up. I have attached the form I use that I created.
I have it all filled out before hand and when that day comes along when needing to order new meds and such, I simply sent it to the fax server to the pharmancy. It gives them my insurance information and other vial info. The pharmacy I have actually like the format I have it in, they have shared it with people who have busy schedules and also use it also.
With all my supplies I rotate them. I also share with people who are in need of supplies and materials. Like infusion sets, glucose strips and such. - Attachments:
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Permalink Reply by Nell on -
I think BC tries to get all their pts to talk to a nurse about managing their health. I have always refused. First, I was a nurse for too many years to count and I think that if your A1c is good, then you are probably managing OK.
But it does bother me that a stranger in an office a thousand miles away is looking at my list of meds and judging that I am not taking one of them.
I, too, like Chadd, try to keep a good stock though I don't manage it for all meds. I also always take two extra weeks of meds when I go on a trip. Accidents or illness can happen. And now, with so many tornados and earthquakes and so on I think it is wise that everyone have at least an extra month supply of all their meds. I know it is hard to do but, as Chadd said, if you learn the earliest you can reorder, then over time you can build up the supply. I always use the oldest meds first, of course.
My own home town was wiped out in the April 17 tornado that went through the south. (I don't live there.) That included that small town's pharmacy, all other businesses and multiple homes. Imagine if your prescriptions were in that pharmacy and also imagine if your doctor's office is destroyed. (there actually were a couple of docs in a clinic in this small town). That possibility alone is enough to make you put all those meds & other essentials in a bag and stash it by the door you use most!
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Permalink Reply by Laddie on -
I think that a lot of these calls result from studies that show how many patients are "non-compliant" in taking their medications. I know that "compliant" is a word that many of us on these boards abhor. However, you must remember that most of us who participate in online forums are "cream of the crop" patients. We are educated about our diabetes and other medical conditions. We may not always follow doctor's instructions blindly, but if we refuse a medication, it is usually because we have done research and have valid reasons for not taking it. Not all of us have great insurance or lots of money, but most of us do our best to get the best tools to optimize our diabetes care.
Many patients in the "real world" don't take their meds or test their blood sugar. There are lots of reasons for this. Some people can't afford their medications. Some people don't really understand the instructions they get at the clinic or doctor and don't have a clue how to take care of themselves. Some people just don't care. You could go on and on.
The idealistic interpretation of these insurance calls is that they are trying to help patients take care of their medical conditions. They want to catch patients who are not taking their Metformin before an amputation or blindness result from years of not taking meds. In the best of all worlds, these calls would result in financial help for people who can't afford meds. They would result in education and support for people who don't understand their medical condition and need help navigating our healthcare system.
Yes, for many of us, this is Big Brother checking up on us. I have always declined the diabetes care programs through my insurance, because I know more about Type 1 than all of the nurses trying to "help" me. These programs are all geared towards Type 2 and are incredibly basic for those of use who know a lot about Type 1. I personally don't get motivated by a workbook trying to help me lose weight and take my pills on time. But maybe some people are and need the support of someone as they learn about diabetes.
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Permalink Reply by fishinglady on -
I got a bill of 300.00+ from my medical supplier for my pump supplies and called them and told them I was sending them back, that I didn't have the money for that co pay and they sent me an application for financial need and I get them cost free now. Have to renew it once a year so there's help if you push the right buttons. They resent my 3 mo. supply back to me. Also not being compliant has its reasons. I am on Actonel for osteroporis and Dr. put me on Omperazole for esophogus and read the insert and it said this drug promoted osteroporis. I never got another scrip filled or took another one. Dr. don't read these inserts I guess. I'm not caring whether my Dr. or ins. knows because I'll just tell them about the interaction. Best read all medicine inserts. Catfish
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Permalink Reply by Nell on
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Well, I can't disagree about the many who don't take their meds properly. Though much of it is due to lack of insurance and cost. I wonder if a study has looked at the groups of inadequate med taking for those who can't afford it vs those who can afford it but choose not to take it.
I am guessing that cost is the big factor but that a small minority would say they don't think they need it. Especially type 2s who initially feel fine and don't "feel diabetic." If we only had health care as standard care for all and not the privilege of those who can afford it (have good insurance) or the very poor. The lower middle class and the 'nearly poor' are left out. Sorry to get going on one of my "things."
Therefore, if the insurance companies find someone not taking their meds, the better question would be "is there anything we can do to help make it possible for you to take your meds?"
Thanks for the point, lathump.
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Permalink Reply by Peetie on -
I'm Type 2 and I stopped my meds because they raised my numbers which led to serious infections and neuropathy. Everything else available has the potential to cause cancer and I already have cancer. I wish there was something safe beyond Metformin to help me. (I already take a low dose). One has no control when taking meds. There is no basal...no bolus.. just 5 min with the endo as he writes another script. One has great difficulty getting even one strip a day prescribed.
Sorry... I just wish everyone would understand that these meds can be worse than the insulin resistance. While most of the T2s I know are terrified, they need to act as if they are not worried. So often I read the posts on here and feel hopeless. Joanne
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Permalink Reply by Nell on
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Can you believe this? I just logged in to medco to check my med status for my endo visit and I had a message that said:
Keep up the good work!
N___, you have met 5 health goals.
Our records indicate you are on track with:
[and they list 4 meds plus 'monitoring your blood sugar']
I did not know I had 5 goals, or any goals with them! Talk about Big Brother! We are all in the database and they now have programs to communicate with our data.
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Permalink Reply by MamaSara on -
I cant get on any insurance at all. Very frusterating. Dont know what to do anymore epecailly with 3 children.
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Permalink Reply by fishinglady on
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What are you medical problems that they are denying you on. I got denied from Mutual of Omaha because I was taking Lasix and Potassium for fluid retention and in their formulary these 2 drugs are for high blood pressure and have never had a blood pressure problem. 100/60 is not an elevated BP. I'm fighting it. Had to get my all my prescription records from my pharmacy for 2 years. Not a verification from my Dr. They said it had been < than 2 yrs. I had been on these meds so have sent that back from 2008. Will have to call them again as it's been over a mo. since I sent them this info. It's an Ins. nightmare. Are your children on any kind of ins. ? Can you get ins. thru your employment?
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Permalink Reply by Aimee on -
I received this annoying call twice (I am with BCBS as well). Then, I called and asked my insurance company to take me off the calling list and I have not gotten one since. The thing that annoyed me the most was that this was an automated system that asked a bunch of questions. I started out playing their game and pressing 1 for yes and 2 for no and then they started asking questions where a simple yes or no did not apply so I got really annoyed and hung up. I tried to press * or # or 0 for an operator first but none of those worked. But then when I thought about it further I thought, "it is none of their business" and made a special call (and even sat on hold) to ask them to quit calling. The data is going to be no good to them anyway as a simple yes or no survey is not going to give them enough information!
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