My first run in with the Affordable Care Act!

In June I got my prescribed 10 test strips per day which equals 300/month. I'm a type 1 diabetic and I test my blood sugar 8-12 times per day because I'm active (I run marathons) and I drive a company car and do NOT want to go low and get in a car accident. So to protect my employer from liability I perform multiple blood sugar checks.

On July 19th I find out that I am now limited to 6 test strips per day! Because of the ACA!! My pharmacist and I are getting a medical pre authorization in process to get me my 10 strips per day but this does not bode well for type 1 diabetics. In order to get an insulin pump, which IS the standard of care for type 1 diabetics, you MUST demonstrate a commitment to your own diabetes care and one of the measures the doctors use is that you check your blood sugars 8-12 times per day to QUALIFY for the insulin pump.

Get the government OUT of my way. I will manage my diabetes with my doctor's and the diabetic communities help. I DO NOT NEED THE GOVERNMENTS HELP!!! My A1C's have been under 7 every time but ONE in the last 17 years since I was diagnosed!

Thank you for your time.

Views: 229

Tags: #aca, #getoutofmyway, #healthcareinthewayofhealthcare, #type1diabetes

Comment by shoshana27 on July 20, 2014 at 5:44am
Just keep doing what you need to do & keep fighting
You need a letter/ prescription from your endo saying how. Many strips you need & why
I get 15 strips per day
Good luck
Don't give up
Comment by rick the "Blogabetic" on July 20, 2014 at 9:23am

This is a general requirement imposed by almost all insurance companies. It applies to Medicare, but also to Blue Cross and Blue Shield private plans. It is a problem. and I understand the frustration. But, if you wish to be angry direct that anger at the proper place. Namely the gray market sales on places like Ebay. Where it is found that folks generally will get a high number of strips not for their own purpose but to resell. It has become an epidemic and unfortunately those of us who use a large number of test strips (I also use 300 per month) are caught in the cross hairs.

To add injury to insult, someone has posted signs around my town offering to purchase test strips 'no questions asked'. The market is very lucrative, if someone is paying for your strips and it is simply a way to reduce abuse.

I am very angry about it, but, I am angry at the marketers of the second hand strips not the companies and federal government who impose limits. Imagine this story were on 20/20 Government pays for hundreds of thousands of test strips which are resold on the gray market and does nothing about it. If that occurred, then most people would say they need to do something about it and the 'government is incompetent, they waste money’ We can’t have it both ways. If we wish the government and insurance to be efficient we have to know that sometimes achieving better efficiency will cause us to be inconvenienced

Again I don't like it either. But when I lash out, I go for those responsible.

Comment by Eucritta on July 20, 2014 at 11:43am

My prescription coverage also restricts test strips; until they were given specific quantities along with a letter of medical necessity, they only gave me enough for three per day. Nothing to do with the ACA - it's *their* policy, not the government's.

Comment by Judith in Portland on July 20, 2014 at 7:59pm

My test strip limit went from 200/month to 50/month years before the ACA. Like Rick, I protested directly to my insurance company---to the top of the regional bureaucracy and also made up a flyer that I sneaked into the appropriate facility to leave on coffee tables in waiting rooms (several times). And also handed the flyer out on a public corner near the entrance.

I never got my 200 strips back, but I get 100/month now and can afford to buy a few more.

The ACA didn't bring this on. Insurance companies and the legislators they fund made it happen. The ACA does make it possible for people who never had insurance before to get it---even if they are struggling with the D with no insurance. Pre-existing conditions don't block access...

Blessings.....Judith in Portland

Comment by pancreaswanted on July 20, 2014 at 9:34pm

i completely understand your frustration. i live in spain and with socialised medicine, i get 3 strips a day. type 1. thankfully i have relatives in the usa and whenever i go, i buy a load of relion strips and my mother the saint sends them to me as well.
i am also quite physically active, i love running, cycling and hiking and trying new sports out. i commute to work by bike and walk/cycle everywhere. in order to do that, i test from 6 to 10 times a day. some days its before noon and ive used up my three strips!
i hope this is just a bump in the road for you and you get what you need! the minister of health and the legislators here, i never wish D on anyone, but i wish it on them so they can see how its impossible to live on three strips a day and be on insulin!

Comment by halford on July 21, 2014 at 1:26am

For the last 4 years I've received 300 strips per month with zero problems. This is not caused by the insurance companies policy! My doctor wrote on the script to test 10times per day due to marathon training and driving company car on the script. This is a restriction caused by the ACA. I now have to jump through hoops to get what I need to live a healthy, happy life. The ACA is the cause of this in my situation.

Comment by Jorychi on July 21, 2014 at 12:45pm

I'm allowed 3 a day by Medicare. Back when I was on Medicaid I got a lot more, but I don't remember exactly how many. If I weren't taking insulin, I would be limited to one a day.

Comment by La on July 22, 2014 at 8:47am
In the uk, if you are type one, you should get as many as is deemed sufficient but this is rigorously monitored as there is a fair bit of money that can be made through selling the equipment. (Selling products to the USA or to type two diabetics half price) A way to show your need is to prove how many you yourself need and how many you use. They will give you, hopefully, sufficient then. At the end of the day, this may not work as i do not know how the insurance companies in the us set these things out.
Comment by brboyer on July 22, 2014 at 9:54am
The ACA is the cause of this in my situation.
No they aren't. Your insurance company is.
Comment by halford on July 24, 2014 at 1:38am

The ACA is the INdirect cause of my situation. The ACA required my employer to change my insurance policy to meet federal guidelines. When my insurance plan changed that activated a Coverage Review Board. Now my test strips are subject to approval by the Coverage Review Board since they exceed the maximum amount of test strips now allowed by my insurance company. In other words. I get to jump through hoops for the next several days while trying to get my endo to call my insurance company's prior authorization board to get my 100 extra test strips approved. I really do not like this bureaucracy that I have to deal with now. Is this going to get better or worse in the future?

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