I received a letter from Harvard Pilgrim Health Care dated February 1, 2012 that informed members that as of April 1st Abbott Diabetic Care meters and test strips as the preferred blood test supplies. This means that those of us on the Medtronic Minimed 723 pump / CGM systems will be paying nearly double for test strips and more for One-Touch glucometers and strips. I think you will also need to request prior authorization for coverage of you current system supplies beginning April 1.
I had a conversation with a HPHC customer representative who robotically said that co-pay coverage for other test strips (Bayer, J&J One-Touch, Truetrack, etc.) MAY be decided on a case-by-case basis if the patient and doctor show a specific need. There are more sanctions but this is enough to report for now.
OUCH! That is painful. I would hope that your Endo can write up something about the requirement of your pump needing a specific meter/strips.
Thanks, Dan, w/ a very supportive endo team.
The opposite happened to me. I have been using Freestyle, and now my insurance will only cover One Touch or Accu-chek as 'preferred'. I like the smaller sample size for the freestyle. I have MM pump, but never cared for the wireless feed of BG, and preferred just entering it manually.
Does a smaller sample size outweigh the manual entry to pump for you ? (FS Meter itself is much smaller too !).
I have found that the OneTouch Ultra meter does not require much of a blood sample. I believe that the amount of blood needed has diminished over the past several years I have had OneTouch meters. This is not to endorse them it's just my experience. The OneTouch Delica meter and lancet are small but I really struggle to draw a sample w/ the shorter lancet. Too much callus on the fingertips I suppose. Anyway, the meter is only good for manaul pump input.
Now that I have been on the MM CGM system for 2 yrs. I have come to accept the limitations. Number 1 is not to rely on the reaading for REAL TIME BG and frequently do a finger stick (8x a day or so). I cheated when I did shots, second guessing my protocol, and do so now but with less frequency. I am trusting the bolus wizard and basal adjustments more. Why do you do choose to do the insulin manually?
Thank you for your response. DW
I used to have MM CGM, but now have Dexcom.
When I had MM CGMS and One touch, I did try for a while to have the BG link to pump, and use the wizard, but after a while found it easier to not use the wizard.
Typically I eat several small meals, with small boluses, and no need for wizard. I never built up confidence in it as you have. I also take other factors into account to calculate my bolus, such as activity level, mix of carbs, protein and fats, and how long since my site/insulin change.
I am in the process of deciding on a pump. I have used dex CGM for 12 months. My question is, how do you combine Minimed pump (which has an integrated CGM system) with Dex? Does than not make one CGM redundant? And was your insurance willing to pay for the 2?
Generally if you say you have a certain pump and it works with a certain meter, then you can get them to authorize (with a doctor's assistance) what you need. My HMO tried to do that to me, and I simply said my pump goes with One Touch and that is all I can use. I think the doctor's prescription was enough to get things covered.
I had that experience a couple years ago and I just had to have my doctor write a letter to the insurance company stating that my pump worked with the OneTouch and I got the same coverage after that.
Thanks, diabud. That's what I'll do.
Now I'm curious about Carelink Pro. I'll have to talk w/ my endoteam.
I see that you are a young adult. If you are participating in this blog it is a good indication that you are working positively with the diabetes. I didn't really get it for a long time (20+yrs) and have (am) paying the price. Stay smart !!
Thanks David. I am trying...not there yet but heading in the right direction I hope.
I had Harvard Pilgrim until last August when I went on Medicare and my former employer had a BCBSMedex policy that suited me better (and cost less) than the HPHC supplemental policies.
But before that, I had several issues with Medtronic and meters/test strips, and I have to say that Harvard Pilgrim was absolutely WONDERFUL to work with! They have always seemed incredibly proactive when it comes to making sure that diabetics have everything they need to take good care of themselves.
If you have a problem, just call customer service and explain it to them, and I'd be willing to bet that they will find a way to resolve it to your satisfaction.
That has definitely been my experience over the past 12 years, as well. No complaints there. I think that the decision remains unjust to all CGM users.