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Medical Forum / Diseases and Disorders / Diabetes / August 2007Best value blood sugar monitor?
One of the joys of having paid for insurance all your life is being told that your needs, when they arise, are not covered. :-) That's what happened me when I was recently diagnosed as a new diabetic: the insurance company used by my HMO told me that "supplies", specifically testing strips, are not covered. Therefore, I'd appreciate your opinion on which monitor is the best value overall: small blood sample, alternate testing sites (are they reliable), and most cost effective strips? I am sure I shall return for much more guidance, but this is what I need to know right away. Thanks. Be interested in name of HMO since I have had many HMO's thru the years and I have never denied. > One of the joys of having paid for insurance all your life is being > told that your needs, when they arise, are not covered. :-) [quoted text clipped - 9 lines] > I am sure I shall return for much more guidance, but this is what I > need to know right away. Thanks. : Be interested in name of HMO since I have had many HMO's thru the : years and I have never denied. "University of Chicago Health Plan", basically run at their hospital complex. To be fair, I was only denied by CVS and by the 800 number at the back of my "drug plan" card (never had to use it so far); I haven't yet gone to all the desks at the university and argued with them. :-) Whatever happens at that end, it is in my own interest to figure out which company provides the best value in glucose monitoring. > : Be interested in name of HMO since I have had many HMO's thru the > : years and I have never denied. [quoted text clipped - 8 lines] > Whatever happens at that end, it is in my own interest to figure out > which company provides the best value in glucose monitoring. Perhaps they do not cover prescriptions from CVS? I have to go to certain pharmacies. Or perhaps you have to get them through mail order? : Perhaps they do not cover prescriptions from CVS? I have to go : to certain pharmacies. Or perhaps you have to get them through : mail order? When the CVS clerk said my supplies weren't covered, that's what I thought, maybe it is just the CVS. But then I called the 800 number, without any reference to CVS, and the person there said my "plan" doesn't cover them. It was night time and I had to leave on a trip the next morning, but now I have to track down the "plan" people at our end. While I'll do that, I must say this experience makes me feel tempted to research "outsourcing" my routine care. I travel abroad a few time a year and it would be easy as well as cost-effective to work with a foreign doctor/hospital for normal monitoring of my health, leaving only emergencies to our insurance run world here. : While I'll do that, I must say this experience makes me feel tempted : to research "outsourcing" my routine care. I travel abroad a few time a : year and it would be easy as well as cost-effective to work with a : foreign doctor/hospital for normal monitoring of my health... Fresh test strips have a long shelf life and you should be able to purchase them on your trips abroad if they are available at significant savings (they probably are). I am sure you realize that the meter being a one-time expense doesn't matter. > One of the joys of having paid for insurance all your life is being > told that your needs, when they arise, are not covered. :-) [quoted text clipped - 9 lines] > I am sure I shall return for much more guidance, but this is what I > need to know right away. Thanks. Just curious... What state are you in? I believe in most states they have to cover them, if a prescription is written. As for the alternate testing sites, they are not as accurate as the fingertip. I believe the Walmart brand is the cheapest in terms of strips and possibly the cost of the meter, but I can't say for sure since my insurance covers them. : Just curious... What state are you in? I believe in most states : they have to cover them, if a prescription is written. Illinois...this is a health plan administered by University of Chicago, imaginatively called "University of Chicago Health Plan". :-) I did have a prescription but was told by pharmacy as well as the 800 number at the back of the prescription drug card sent me by the university that "supplies" were not covered. I'm using a one touch UltraMini put out by J&J. I'd google that name and get their web site with the 800 number. Call and speak to a rep.My guess is that they will be more than glad to send you a free one. I don't pay for stripes so can't help there. Meters are like Razors. They can afford to give out the meters since their money is made on strips/razor blades. > : Just curious... What state are you in? I believe in most states > : they have to cover them, if a prescription is written. [quoted text clipped - 5 lines] > number at the back of the prescription drug card sent me by the > university that "supplies" were not covered. >As for the alternate testing sites, they are not as accurate as the >fingertip. Can you point to a reference somewhere that supports this? I've researched this a couple of times and all I've ever been able to come up with is that changes in blood sugar register faster at the fingertips, but as for overall accuracy the difference between forearm testing and fingertip testing is statistically irrelevant. Would definitely be interested in any supporting evidence either way, things on the net I can read the better. : >As for the alternate testing sites, they are not as accurate as the : >fingertip. : Can you point to a reference somewhere that supports this? I've : researched this a couple of times and all I've ever been able to come [quoted text clipped - 3 lines] : definitely be interested in any supporting evidence either way, things : on the net I can read the better. My endo, who old me to never use the alternate sites possible with the meter he gave me. Wendy In alt.support.diabetes on Tue, 7 Aug 2007 02:50:48 +0000 (UTC) in Msg.# > : >As for the alternate testing sites, they are not as accurate as the > : >fingertip. [quoted text clipped - 9 lines] > My endo, who old me to never use the alternate sites possible with the > meter he gave me. So, it is possible that that meter is not one that can do alternative sites. You've never mentioned that bit before. Thanks. Still happily testing on my thighs ...  SignatureDonnaB 06-07-06 Diagnosis T2 hbA1C 8.1, D&E & Metformin 500mg ..................09-11-06 hbA1C 5.0 ..................12-20-06 hbA1C 5.2 ..................05-18-07 hbA1C 5.3 : In alt.support.diabetes on Tue, 7 Aug 2007 02:50:48 +0000 (UTC) in Msg.# : > : >As for the alternate testing sites, they are not as accurate as the : > : >fingertip. [quoted text clipped - 9 lines] : > My endo, who old me to never use the alternate sites possible with the : > meter he gave me. : So, it is possible that that meter is not one that can do alternative sites. : You've never mentioned that bit before. Thanks. : Still happily testing on my thighs ... My meter does do alternative sites with a special tip for the lancr, but I was told not tot use it. He wants fingertips. Wendy Has anyone else been told either way by reliable sources, i.e., doctors/dietitians/diabetes educator, etc? I've never found a satisfactory answer myself, even my doctor and dietician disagree (doc says alternate site isn't accurate to the best of his knowledge, dietician/educator said they are reliable enough)... Here's a few references I found online: http://www.liebertonline.com/doi/abs/10.1089/15209150252924157 http://care.diabetesjournals.org/cgi/content/full/28/3/710 http://www.smw.ch/docs/pdf200x/2002/25/smw-09991.PDF http://www.lifescan.com/products/meters/armtesting/alternatesite/#difference http://spectrum.diabetesjournals.org/cgi/content/full/14/4/193 http://www.medscape.com/viewarticle/541546_4 http://www.diabeteshealth.com/read/2001/11/01/3417.html They have some differing opinions in some areas, but overall the conclusion at least I draw from reading them all is that forearm testing, probably the most common alternate site, isn't usually too much less accurate than fingertip testing, with caveats about the speed at which you'll observe changes. >: In alt.support.diabetes on Tue, 7 Aug 2007 02:50:48 +0000 (UTC) in Msg.# > [quoted text clipped - 21 lines] > >Wendy In alt.support.diabetes on Tue, 7 Aug 2007 13:08:34 +0000 (UTC) in Msg.# > : In alt.support.diabetes on Tue, 7 Aug 2007 02:50:48 +0000 (UTC) in Msg.# > [quoted text clipped - 19 lines] > My meter does do alternative sites with a special tip for the lancr, but I > was told not tot use it. He wants fingertips. Okay, that puts us back to the same situation where yours says not to use alternative sites & mine says they are fine if used according to their specifications. SignatureDonnaB 06-07-06 Diagnosis T2 hbA1C 8.1, D&E & Metformin 500mg ..................09-11-06 hbA1C 5.0 ..................12-20-06 hbA1C 5.2 ..................05-18-07 hbA1C 5.3 : Okay, that puts us back to the same situation where yours says not to use : alternative sites & mine says they are fine if used according to their : specifications. A few members of this group could settle this by testing on their fingers and alternate sites a few times themselves. I did this probably 50 times when I first starting testing... the difference was never more than 10 mG/dL either way. >: Okay, that puts us back to the same situation where yours says not to use >: alternative sites & mine says they are fine if used according to their >: specifications. > >A few members of this group could settle this by testing on their >fingers and alternate sites a few times themselves. > ....I was recently diagnosed as a new > diabetic: the insurance company used by my HMO told me that "supplies", > specifically testing strips, are not covered. Ask up the food chain, don't just take the word of the first person you talk to. If it's a group policy through your work, ask the HR/benefits person about it. Find out if perhaps supplies are covered under some different provision than whatever you tried. It's the strips, not the meter, that cost the real money so don't worry too much about the cost of the meter itself -- besides, meters can often be had for free or nearly so. Check with any state insurance regulators if diabetes supplies are required to be covered. bj : Ask up the food chain, don't just take the word of the first person : you talk to. If it's a group policy through your work, ask the HR/benefits : person about it. Find out if perhaps supplies are covered under some : different provision than whatever you tried. I intend to do this soon. I have never needed any care really, just paid insurance, :-) so I signed up for whatever most people here seem to choose. It is likely that another plan would suit me better. I'll definitely research this. But these are the moments when you feel like outsourcing the whole health care industry. Our country has done such a lousy job. By a rough estimates, I have paid into the system for 20+ years, asking almost nothing in return. Yet the first time I have a need, they shamelessly tell me it is "not covered". > : Ask up the food chain, don't just take the word of the first person > : you talk to. If it's a group policy through your work, ask the [quoted text clipped - 13 lines] > almost nothing in return. Yet the first time I have a need, they > shamelessly tell me it is "not covered". It's not likely that another plan would take you, now that you have diabetes. Often they won't cover pre-existing conditions. : It's not likely that another plan would take you, now that : you have diabetes. Often they won't cover pre-existing : conditions. I think OP should find out if he can switch from one plan to another within the same HMO. That need not be out of the question. > I have never needed any care really, just paid insurance, :-) Didn't they explain to you that that's the was the way it's supposed to be? You have to read the fine print. John In alt.support.diabetes RPS <rps@null.void> wrote: : : Ask up the food chain, don't just take the word of the first person : : you talk to. If it's a group policy through your work, ask the HR/benefits : : person about it. Find out if perhaps supplies are covered under some : : different provision than whatever you tried. : I intend to do this soon. I have never needed any care really, just : paid insurance, :-) so I signed up for whatever most people here seem : to choose. It is likely that another plan would suit me better. I'll : definitely research this. : But these are the moments when you feel like outsourcing the whole : health care industry. Our country has done such a lousy job. : By a rough estimates, I have paid into the system for 20+ years, asking : almost nothing in return. Yet the first time I have a need, they : shamelessly tell me it is "not covered". Unfortunn atly, you may find it difficult to change plans now that you are diagnosed as a diabetic. Jus tone of the catch-22's of the US medical system. Wendy >> ....I was recently diagnosed as a new >> diabetic: the insurance company used by my HMO told me that "supplies", [quoted text clipped - 11 lines] > Check with any state insurance regulators if diabetes supplies are > required to be covered. There is a meter currently for sale on drugstore.com that has a $50 rebate. The meter itself was something like $70. : There is a meter currently for sale on drugstore.com that has : a $50 rebate. The meter itself was something like $70. As many have pointed out, cost of the meter is hardly an issue. It is the strips OP needs to research. > : There is a meter currently for sale on drugstore.com that has > : a $50 rebate. The meter itself was something like $70. > > As many have pointed out, cost of the meter is hardly an issue. > It is the strips OP needs to research. Um... I know that. I believe I was the first one to respond to him. >: There is a meter currently for sale on drugstore.com that has >: a $50 rebate. The meter itself was something like $70. > >As many have pointed out, cost of the meter is hardly an issue. >It is the strips OP needs to research. N my opinion the meter are perfectly adequate for their intended use. The meter are given away if a person will investigates. The strip cost is typical for gross excess costs of medical items based or pay or die. Non technical people seem to expect too much from any device. I doubt if the cost situation will ever change. Only a fool will to manage diabetes with a blindfold on. But as one tech said tome "why get the data, they don't know what it means. I took exception to that statement. MHD and ASD has a pretty good track record on that issue. : But as one tech said tome "why get the data, they don't know : what it means. While that may be technically true of a very complex set of numbers, I think even non-techs can figure out which BG levels are good or low/high for them. So monitoring is good. I'd suggest OP should find out which strips are available to him at the lowest cost (it is perfectly ok to source them from abroad or Internet or whatever, as long as they are factory sealed). Among those, choose the one needing smallest blood sample. Finally, while not making the monitor's cost a factor in deciding which one, try to get it for free or as little as possible. In the long run, this will matter the least. No one ever told me that test strips would be covered by prescription, so I had always bought my test strips at Walmart. I looked for the least expensive strips first, then bought the meter to match. :) And I liked it so well, that I have had two of them. I have an Accu-chek Active. The meter itself is really inexpensive at Walmart (I've seen them there for around $20, and as low as $5 if they're on sale), and the test strips are $27.94 for 50. However, my HMO, Blue Cross, gets me the test strips (with a prescription), so I have to pay the co-pay, which is $30, BUT I get a three month supply for that $30 when it used to cost me approximately $84. I do have to use the mail order service, meaning I have to keep tabs and see that I don't run out, though. And I just got a new free meter, the Ultra-Smart (the one with the built-in logbook), whose test strips are more expensive if I bought them through Walmart, but my HMO says that the cost for the strips through them are the same as the old ones if I get a prescription for those. That is, if I choose to switch. Still debating on which would be the better one to have. Bottom line is, tell your doctor you need a prescription. Honestly, the lack of voluntary information from HMO's is scary sometimes. Until someone else told me they got THEIR test strips that way, I never knew. And my HMO certainly never voluntarily sent me any information, even though they knew I was diabetic from the meds that got ordered. > One of the joys of having paid for insurance all your life is being > told that your needs, when they arise, are not covered. :-) [quoted text clipped - 9 lines] > I am sure I shall return for much more guidance, but this is what I > need to know right away. Thanks. 1) as far as I can determine there is no major difference in accuracy from meter to meter. 2) most modern meters use quite small samples. 3) you should be able to get a meter for free or very little expense. The cost is in the strips. The Walgreen's strips go for $50/100 - the others that they sell run around $100/100. I believe that WalMart may have house brand strips for a bit less. : 3) you should be able to get a meter for free or very little expense. : The cost is in the strips. The Walgreen's strips go for $50/100 - : the others that they sell run around $100/100. I believe that : WalMart may have house brand strips for a bit less. One genius of our health care companies is that they sell the same products much more cheaply to foreigners! Another is that while denying coverage to one person, they give enough spares to others to sell on eBay. Simple economics suggests that we should learn to reimport such items from abroad. Test strips have long a shelf life and are perfect candidates for that. I think a determined shopper can buy them for 15-20 cents each, about 1/3 of the lowest US costs. A good friend gets his this way. > : 3) you should be able to get a meter for free or very little expense. > : The cost is in the strips. The Walgreen's strips go for $50/100 - [quoted text clipped - 11 lines] > 15-20 cents each, about 1/3 of the lowest US costs. A good friend > gets his this way. I favor a simple 'mirror law' - they should not be able to charge us any more than any other civilised country. So Canada, for example, has price controls - so what - they obviously make a profit there or they would not continue to sell there - so why should it cost us any more? Of course another part of the problem is that with the previous advertising ban lifted, the med companies now spend more on advertising than on R&D. > 2) most modern meters use quite small samples. > > 3) you should be able to get a meter for free or very little expense. > The cost is in the strips. The Walgreen's strips go for $50/100 - the > others that they sell run around $100/100. I believe that WalMart may > have house brand strips for a bit less. $40 / 100 shipped, for Home Aide Diagnostics, at americandiabeteswholesale.com. It's 0.7 sample size, fine for me. 1.0 for my Walgreens special ('TrueTrack') was a bit more than I liked, but this one is fine. | One of the joys of having paid for insurance all your life is being | told that your needs, when they arise, are not covered. :-) [quoted text clipped - 9 lines] | I am sure I shall return for much more guidance, but this is what I | need to know right away. Thanks. interesting, to date there are only 4 states that don't require diabetic supplies to be a mandatory cover under insurance policies. I don't think Illinois is one of them. you might call your state medial office and ask then go into your employer fully armed. >One of the joys of having paid for insurance all your life is being >told that your needs, when they arise, are not covered. :-) > >That's what happened me when I was recently diagnosed as a new >diabetic: the insurance company used by my HMO told me that "supplies", >specifically testing strips, are not covered. Insurance companies may vary as to *how* test strips are covered. One company covered them (at, I think, 90%) under major medical, subject to a deductible. If you asked the prescription drug plan about them, they were NOT covered, and that plan didn't know anything about them. Another company handles them under the prescription drug plan. They got kinda confused and at first I thought they would make me replace a perfectly good and relatively new meter. Unlike prescriptions, they are subject to the deductible, but after meeting that, the cost is $0. Both of the above companies are called "Blue Cross" (different employers). >>One of the joys of having paid for insurance all your life is being >>told that your needs, when they arise, are not covered. :-) [quoted text clipped - 16 lines] > > Both of the above companies are called "Blue Cross" (different employers). My Blue Cross covers strips at a $30 copay for ones on the fomulary. For ones not on the formulary, they run about $36 (all prices per 100). I appreciate all the responses to my post below. Being a newbie I had not realized the complex ways in which HMO and insurance can work. As some of you had suggested, it was a good idea to keep asking questions and kicking it upwards. My hospital pharmacy, CVS, prescription drug plan, etc., had all said strips are not covered because *they* don't cover them. Our HMO has recently contracted a company to just supply diabetic supplies by mail order. This is so new that even doctors, nurses and much of the staff seem unaware of the change. Our HMO uses Freestyle Freedom monitor and strips. So that's what I'll use. Thanks to everyone again. : One of the joys of having paid for insurance all your life is being : told that your needs, when they arise, are not covered. :-) [quoted text clipped - 9 lines] : I am sure I shall return for much more guidance, but this is what I : need to know right away. Thanks. > My hospital pharmacy, CVS, prescription drug plan, etc., had all said > strips are not covered because *they* don't cover them. Our HMO has > recently contracted a company to just supply diabetic supplies by mail > order. This is so new that even doctors, nurses and much of the staff > seem unaware of the change. Now you have to find out *exactly* how the prescriptions should be written to get the number of strips that *you* consider necessary at the least cost. When I say *you* I mean -- you figure out how much testing you want to do that will be useful to *you* in learning about *your* diabetes (response to meals, exercise, etc), not just how much testing will be useful to your doctor. Then ask for the prescription that will give you enough strips -- and depending on your HMO, the wording may have to be precise (# of strips, times-per-day, whatever). You may have to be prepared to make a strong case to your prescriber (NP? doctor? whoever) that you need that many strips -- not only is it unusual for people to do as much testing as those of us here do, the medics don't understand how useful it can be. Best wishes. bj |
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