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Medical Forum / Diseases and Disorders / Diabetes / March 2006Insurance coverage for testing supplies
Hi: I was wondering what I can do to reduce the cost of testing supplies (strips mainly) ? Does your insurance cover these supplies ? I am testing 8-9 times a day (its the learning phase of my experience - I expect to settle down to 5 or 6 times once I figure out what works but even then I see the cost as being high). Any ideas ? Thanks! Dave H. > Hi: > [quoted text clipped - 13 lines] > > Dave H. our Bluecross coverage provides 100% coverage for strips. Between my wife and I, we get 1,000 strips for free per month. That's the good news. the bad news is they have a cap on DME, which means I can't get a new pump for less than $2,400 out of pocket. Neither one of us has a pump that is currently under warranty so if they break, we are screwed. Dave >> Hi: >> [quoted text clipped - 21 lines] > >Dave Hello Dave, How are you and Mary making it tonight? I hope everything is OK out there in CA. I just wanted to make the observation that insurance companies are not benevolent organizations. The reason they let you have 1,000 strips per month is that they figure it is in their best interests to facilitate diabetics becoming well informed about their conditions. My insurance company calls and sends letters to make sure I am getting various tests and getting my strips... They WANT you to test; they WANT you to know your test results; they WANT you to be motivated to do better and improve your condition. Not because they love you, but because they want to minimize their costs in the end. It is all about money... and minimizing their exposure. Will, T2 Wow -- 1000 strips? That's a bit over 16 tests per day for each of you. Awesome! I've found with my insurance company, I have to request 11 test strips a day, wait 3 weeks for the insurance company to talk with the doctor, and get it knocked down to 10 tests per day. If I ask for ten, it's likey that I'll get less than that. One ER visit would cost many, many boxes of test strips, so it's nice that they do that. It's starting to be a worrying trend -- a lot of companies are moving to a 50% co-pay model for prescriptions. Even at 50%, eBay (and some online) sources selling strips can even cost less than half retail. Let's hope that doesn't happen to everyone... >Wow -- 1000 strips? That's a bit over 16 tests per day for each of >you. Awesome! I've found with my insurance company, I have to request [quoted text clipped - 9 lines] >online) sources selling strips can even cost less than half retail. >Let's hope that doesn't happen to everyone... I've been seeing accu chek prices on ebay exceed Relion prices at walmart. I have a hunch the stick vendors are also behind this legislation. If passed, I would expect their profits to explode since we will be forced to purchase retail where they can raise prices at will. Walmart just raised prices on sticks. If passed, David will no longer be using 1000 OTU sticks per months. At Walmart that would cost HIM $90/100 sticks = $0.90 per stick. 1000 x $0.90 = $900 per month just for sticks. A lot of people using accu chek or Lifescan products will dump them almost immediately. > our Bluecross coverage provides 100% coverage for strips. Between my > wife and I, we get 1,000 strips for free per month. That's the good [quoted text clipped - 3 lines] > > Dave My Blue Cross policy has me paying full retail for all strips until I reach my yearly deductible of $4,000. I called them on diagnosis and they said "oh yes you're covered for 200 strips per month." They left out the little bit about me having to pay 100% of the cost though. If anyone's insurance pays even a penny you got mine beat :-) Paul > I was wondering what I can do to reduce the cost of testing supplies > (strips mainly) ? > Does your insurance cover these supplies ? Do you already have insurance? If so, then ask them what they cover -- particular brands? any limits? My plan covers whatever the doctor prescribes, but I have to be sure the scrip is written "just so" to get maximum benefit from it -- find out any such rules, tips & tricks. Then tell your doctor how to write the scrip -- give exact wording, if necessary! (my plan covers strips, but not the meter itself) For instance, if I get a scrip to fill locally, it needs to be for (up to) 34 days. And the directions have to say how many times a day to test, not just "use as directed". If the scrip just says "100 strips" then that's all I'll get, and insurance will assume that's for 34 days (& won't cover a refill until then). If the scrip says "test 6 times/day", that would be 204 strips -- but since strips come in boxes of 50, I'll only get 200 (which is fine with me, that's close enough); "5/day" would be 170 strips, but I'd only get 150 (they can't dispense *more* than the rx calls for) but they'd consider it a 30 day supply & I can refill sooner (& pay the copay more often). For mail order (my insurance has a designated m.o. pharmacy), I get 90 days supply -- but the same "scrip writing rules" apply so I'm careful about how I get them worded. However, my plan also has an annual cap on rx coverage. My strips use up a lot of it! But I do use other meds & I have exceeded the cap at least once. bj Ouch! That would hurt me really, really bad!! My co-pay is bad enough as it is! However, we will be going on Tricare on the 1st, and our co-pay will go down considerably. Billie  Signaturebh-wages at swbell.net ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ But I do use other meds & I have exceeded the cap at least once. : bj > Hi: > [quoted text clipped - 9 lines] > > Any ideas ? This depends a lot on where in the world you live and the type of medical insurance you have. If you're in NJ or PA, medicare and medicaid recipients are able to get testing supplies for free. Where I live in NJ, private insurance companies do not have to underwrite the entire cost of testing supplies, but if you have a prescription plan, the plan has to include testing supplies too. Your best bet is to check with your doctor or pharmacist. You may also try googling for the subject and searching any web sites that your local government may maintain. My health insurance pays for my testing supplies. Have you called yours to find out. Loretta -- In tribute to the United States of America and the State of Israel, two bastions of strength in a world filled with strife and terrorism. "I was wondering what I can do to reduce the cost of testing supplies (strips mainly) ? Does your insurance cover these supplies ? " HI Dave, If you are in the US, your insurance (if you have it) is required to cover testing supplies in 46 states--all except Ohio, Alabama, North Dakota and Idaho. Insurance in those 4 states may or may not cover it. This requirement, and the requirement to cover education and medications for diabetes in those 46 states is currently in jeopardy as the House and a Senate Committee have passed a bill, S1955, that would do away with statewide regulations like this one. That is why it is so important for us all in the US to get on the horn, or type up some letters to our Seantors and ask them to vote NO on this bill. If you don't have insurance, the best you can probably do is look for a meter that uses cheaper strips. Strips can be had for as low about $45 per 100, about half what most of them cost, if you use the house brand of meter sold at Target, Costco or WalMart. Ask at some of the bigger chain drug stores--they may come close to that price--or not. These cheap meters can be had for $10-20, and are as accurate as their more well-known counterparts, but lack features such as downloading to a computer, being real quick or very easy to read, or keeping lots of data in their on-board memory. Morris > If you don't have insurance, the best you can probably do is look for a > meter that uses cheaper strips. S > > Morris or look on eBay. dave People have reported mixed results with eBay Strips. They can be cheaper, but can also arrive and be out of date. They can also be exposed to temperature variations in shipping that are harmful to the strips so quality can be issue. An interesting question is where these strips come from. Aside from possibly stolen strips, most likely they are from diabetics who are not testing, from diabetics who are prescribed to test 8X/day but only test twice, or from relatives of deceased diabetics who keep filling the prescription. Because they are bought with just an insurance co-pay, they can be sold at a profit for less than retail. Which may be part of the reason that insurance companies are sometimes reluctant to approve too many tests per day. Morris > > If you don't have insurance, the best you can probably do is look for a > > meter that uses cheaper strips. S [quoted text clipped - 4 lines] > > dave > People have reported mixed results with eBay Strips. They can be > cheaper, but can also arrive and be out of date. They can also be [quoted text clipped - 21 lines] >> >>dave "let the buyer beware". Good slogan, huh? <g> dave >People have reported mixed results with eBay Strips. They can be >cheaper, but can also arrive and be out of date. They can also be [quoted text clipped - 10 lines] >Which may be part of the reason that insurance companies are sometimes >reluctant to approve too many tests per day. The only problem with sticks from ebay is that they are becoming way overpriced. Expired sticks are not a problem if you use them within a year of expiration date. I do it all the time. At about 18 months beyond expiration, there is a visible variance between sticks. When our beloved beltway corporate whores pass the legislation so insurance companies do not have to pay for diabetic supplies, a lot of people will be getting their sticks off ebay or go without testing. I wonder if the stick vendors are behind that BS legislation as are the insurance companies? Since the insurance industry negogiates stick price with the stick vendor, the stick vendors do not make much money. But, if all diabetics were forced to buy their own sticks, stick vendor profits would go through the roof. If passed, I would expect the supply on ebay to disappear. HI there, I would agree that if this legislation passed and insurance companies eliminated coverage for test strips, that the eBay supplies would vanish. However if companies stopped covering them, then a lot of people would test less often, shrinking the market for test strips, and the market would tilt towards those manufacturers who produce the cheapest test strips. Meters with smaller samples and computer downloads and quick testing time that now can charge a premium for strips would lose market share. For those reasons I doubt if those manufacturers favor this legislation. Morris > >People have reported mixed results with eBay Strips. They can be > >cheaper, but can also arrive and be out of date. They can also be [quoted text clipped - 27 lines] > > If passed, I would expect the supply on ebay to disappear. |
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