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"I Don't Like the New Changes at All"

Oct 30, 2013

Editor's Note: We received this e-mail yesterday from a long-time reader. As we read it, we realized that she may be expressing thoughts and feelings shared by many of our readers. That's why we would like to invite you to respond to what she says, and add your own observations. Please feel free to comment. (To protect this writer's privacy, we are not publishing her name.)

Nadia Al-Samarrie, Publisher and Editor-in-Chief


Dear Nadia:

My husband and I have Blue Cross and Blue Shield, and we have Express Scripts that covers our prescriptions.

Recently I got a note in the mail that they would no longer cover any glucometers except OneTouch. I am on the OmniPod insulin pump and I use FreeStyle test strips that go along with my glucometer, which is better known as the Personal Diabetes Manager.

The OmniPod is an insulin carbohydrate ratio insulin pump system. Before that I used AccuChek test strips. [However] Express Scripts will no longer cover any tests strips except OneTouch.

I would love to know what other diabetics think of these changes. I don't like the new changes at all. I can see the President helping people get insurance that can't afford it, but for the people who can afford and have insurance, and pay a portion of the insurance out of their own pocket, I don't think they should be denied the right to use any glucometer they want.

Testing your blood sugar sure helps you stay in control and keeps you out of the hospital. I think it is a shame that with the new insurance changes they will only cover one brand of test strips. I also got a note that they only insulin they will cover now is Humalog insulin. What about all the other people that use Lantus and other long-acting insulin?

I sure thought we were past all these stages in the game with diabetes. I remember years ago when I first started working after college I always had to have the more expensive insurance plan or none of my diabetes supplies would be covered. I remember when some people I worked with had insurance plans where when they took their children to the doctor the office visit was only $5. I could not have that because that insurance wouldn't cover any of my diabetes supplies because they claimed they were disposable. Many years later all our diabetes supplies were covered.

Now with the new prescription plan changes we are going backwards again instead of forward with the changes being made. Very few of our things are going to be covered now by Express Scripts. I don't think it is fair for the people that have diabetes. I have had diabetes for over 40 years. I would love for you to do an article in you Diabetes Health magazine and hear from other people what they think about all this.

L.S., Delaware


Categories: AccuCheck, Blue Cross, Blue Shield, Express Scripts, FreeStyle, Omnipod, Personal Diabetes Manager

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Posted by Anonymous on 30 October 2013

I had the same problem but I shopped around within companies that take my insurance until I found one that would supply my brand of strips
You don't have to use express scripts just because you have Blue Cross insurance.

Posted by Anonymous on 31 October 2013

It's my understanding that companies choose the structures and coverages of the plans. You should speak to your employer as they buy plans with certain coverages. At least that is my understanding.

Posted by Anonymous on 4 November 2013

I wanted the article writer to know that it may not be as convenient but you can use ANY glucose meter and strips while using an Omni Pod; you just enter it differently in the PDM with no problem. I recently went on the Omni Pod and had other meters and strips so I'm still using them. I haven't gotten to use the meter they sent me yet!

Best of luck to you!

Posted by Anonymous on 5 November 2013

I have an Animas Ping I received a little over a year ago because my Animas 2020's screen went out after almost exactly having it 5 years. I had been using Freestyle meter and strips and liked them better than the One Touch I started out with 10 years ago when I was first diagnosed. I liked the Freestyle much better as it took less blood and required no coding. I did not waste strips by not getting enough blood on the strip like I did the One Touch. And now I have the same problem again because the Animas Ping comes with a remote/meter from One Touch using the same meter and strips. Also, I have Blue Cross Blue Shield and they quit covering Freestyle. Yes, they pay for the strips and pump supplies but I hate the meter and will be stuck with it for another 4 years or however long my pump lasts. It is definitely not fair that the insurance companies decide which meters we can and cannot use.
I have never tried the Omnipod or any other pump. I feel stuck with Animas. The only reason I went with them in the first place is Minimed did not call me back and Animas did.

Posted by Ted Martin on 5 November 2013

While the focus here is trying to deal with socialization of American medicine, the bigger problem is what this president is attempting to do to the American system. This is just the beginning of our problems as anyone in England or Canada can vouch for.

Posted by Anonymous on 5 November 2013

It seems to me that the ACA gave the insurance companies a reason to raise rates and lower benefits. Same company both employer and insurance. Less benefits higher costs.

Posted by Anonymous on 5 November 2013

I too have express scripts. I have a revel pump and use the one touch meter that wirelessly sends your glucose result to my pump. Earlier this year express scripts informed me that they would only cover Roche Accuchek meters and strips. So I had to switch meters. Now less than a year they inform me I have to switch back, which is ok for me but all this switching is exasperating.

Posted by Anonymous on 5 November 2013

That's very interesting. I've had Type 1 for over 60 years & the pump was the only thing that got my severe glucose swings under control. I got a similar letter from my insurance, GemCare Medicare Plus, an HMO supplemental plan, but with different products. My letter said they no longer cover meters/strips other than Abbott Diabetes Care FreeStyle products. I use an Animas Insulin Pump and OneTouch meter/strips. I am still waiting for a call back from the pharmacist to tell me how I'm supposed to deal with my situation. Are they going to buy me, free of charge, a new OmniPad pump to go with the new, free of charge, FreeStyle meter they will provide to me? I doubt it. GemCare says their decision has nothing to do with Obamacare, but I doubt that also. I am really angry at this development!

Posted by Anonymous on 5 November 2013

Also, at this point, it's not Obamacare making those decisions and changes. It's the Insurance companies. And they have been doing this for a long long time. Several years ago I had to switch companies because of changes they were making with both my doctors and some meds I had been taking . Anyway, I think that if we all just give obamacare a fair chance, we will come to like it just as much as Medicare and Social Security, both of which were looked at very suspiciously. :)

Posted by Anonymous on 5 November 2013

I believe the one very important point that is being overlooked in the email from this concerned person with diabetes is that he/she has diabetes and has had it for over 40 years. Before Obamacare or the AHA, that person could not get health insurance unless they paid an extremely high premium. something even then they just were not allowed to get health insurance because of a little thing called "pre-existing condition."

My husband has had diabetes for about as long as the person who originally wrote this post. The last job he took (computer programmer) before he retired about 11 years ago, he had to lie that he didn't have a pre-existing condition!

Because of President Obama we can all rest easier and not be concerned that we won't be accepted by an insurance company nor will we need to worry about the insurance companies putting a lifetime cap on our coverage or kicking us off the plan because we have developed an expensive illness.

I am sure there is a solution to L.S. in Delaware's issue. I wish I had a bit more time to spend on it because I know I could find one.

Just remember how important this healthcare act is to everyone. Let's not be intimidated by lies and false statements trying to get us to write our representatives, etc. Not that L.S. is doing that but it's important to have mindfulness about back room manipulation of the public perception of a healthcare law that will truly benefit all of us. Yes, there may be some inconveniences at first however, the long term benefits far outweigh those minor issues.

I hope someone can help L.S. and I wish her/him all my very best.

Posted by Anonymous on 5 November 2013

It seems we are all at the mercy of what our insurance companies and their in-plan facilities allow. Especially with Diabetes, it often seems 'medical' runs our lives. The mail-order pharmacies have two main advantages, lower prices and larger quantities. The trade-off is impersonal service and limited selection, as these help them reduce costs.

After a negative experience with Medco (my insurance's only mail-order option), I looked for some creative options and here's what I came up with.

1. Some local pharmacies offer 90-day prescriptions, such as Walmart and Costco, other's don't.
2. If quantities are limited by your insurance company (such as a max local prescription of 100 pills, even when the 90-day quantity prescribed is 180 or more), team with your doctor to write greater mail-order doses, or double-dose pills that can be cut in half, or multiple generic prescriptions and fill one locally under insurance and locally without insurance (IE Walmarts $4 generics).
3. With meters and test strips, the big expense is the strips, not the meter, so shop around. Walmart's store brand strips are the best cost-per-strip I've found locally.
4. With pen-style insulin, ask your pharmacist if they sell generic needles.

I'd love to read tips other people have learned for keeping Diabetes maintenance manageable!

Posted by Anonymous on 5 November 2013

Welcome, to Obamacare. Our insurance plan recently changed and we have much higher deductibles, Our old plan was just too expensive for my employer to keep, since the premiums almost doubled. So now my NovoLog flex pens cost $829 out of pocket For a three-month supply And the Lantus is $630.. Who can afford that? Trying to cut back on my insulin is not an option. I need it to live. I am very fearful that next year Will be much worse. After all, Obamacare has not even Started yet. I will have to put my insulin on a credit card. No other choice. Something needs to be done and fast.

Posted by Anonymous on 5 November 2013

I use the accuChek and am having a hard time finding a company who sells sthem. I have called over 17 companies and have not found them. I use that meter and also use a continuous blood glucose meter with it and medicare hassaid that I use too many strips and will not pay for them. I hate to change meters but may not have a choice-or give up my CBG meter.

Posted by Anonymous on 5 November 2013

Same problem with diabetes testing supplies,have Accu Check Compact and my supplier is not authorized ,had to find new supplier and before I could get supplies that company sold to my old supplier now I am back to beginning ,waiting on call from supplier for direction.Seeems like we do not have people who know making decisions as to our health.

Posted by Anonymous on 5 November 2013

I must agree with the comment about not liking the changes. I recently had to purchase a new insulin pump. It came with a One Touch meter that talked directly to the Animus pump. I am informed that the company that sold me the meter does not cover the test strips because of who my primary insurance company is. I must now choose another meter and strips, which does not talk to my pump.

Posted by Anonymous on 5 November 2013

I recently received a letter from prescription agency associated with my health insurance, stating they will no longer cover Bayer Contour strips (and meter) for some random reason. No mention was made by them that I use a Medtronic pump. Five meters/strips were mentioned that they'll now cover. I looked up all five online - not one was appropriate to use with the pump; I looked on Medtronic website and they only mention the Bayer Contour linking up with the pump, no other meters/strips. Well this was totally insane thinking by my insurance company. There's no question I need the appropriate meter to link up with the pump. As my final step, after doing my "research" I called the prescription company to ask about the letter and express my concern. Total surprise: they have no record of any such letter in my file, they know that Bayer only links with the Medtronic pump, there's no reason I need to change meters and strips, they were very puzzled. Plus in my file it states I am still covered this year and next for the Bayer product, no changes pending. Before accepting any insurance company's letters stating their new procedures, give them a call. It might be an error on their part and in actuality you're still covered and have no changes pending. Don't always figure what they convey is correct, they all make unfortunate mistakes.

Posted by Anonymous on 5 November 2013

Your 1st 3 comments are MISSING the point. We are already more than inconvenienced by having Type 1 Diabetes and it was nothing we did to ourselves as in many other diseases. After many years and taking excellent care of myself I am in End Stage Renal Failure. That is the next thing to go, "Thanks Obaminationcare"! WE NEED CHOICES. We are paying a fortune for insurance and mine has gone up dramatically! Where is the affordable part????? Other countries do it just fine and much better.

Posted by Anonymous on 5 November 2013

I completely understand where the writer is coming from. We are covered by Blue Cross Blue Shield of MA and they cover the OmniPod at their Tier 2 level but the strips made to go exclusively with the OmniPod PDM are NOT covered. You have to jump through the hoop of having your physician write a letter of necessity so they can issue of "formulary exception." After that is approved, then they will cover the FreeStyle test strips at a Tier 3, which translates to 5 times what we were paying for OneTouch Ultra test strips when our daughter was on the Animas Ping. I filed a grievance with BCBS of MA but to no avail. My biggest question, which remains unanswered, is why would they cover a medical product like the OmniPod at one level and not cover the ONLY strips that go with the PDM? We suspect Abbott Labs, maker of FreeStyle strips, is charging an arm and a leg and BCBS of MA doesn't want to foot part of the bill. It is also interesting to note that residents of Massachusetts are not eligible for the FreeStyle Promise Program. When our daughter received her first supply of pods, a yellow card from Abbott Labs, maker of the FreeStyle test strip, promoted a co-pay savings program. But the fine print reads:
Co-pay assistance is not valid for residents of Massachusetts. Hmmmmmmm. In the meantime, Type 1's who may get better control with the OmniPod are going elsewhere because the FreeStyle strips (at least in the state of Mass.) are cost-prohibitive.

Posted by Anonymous on 5 November 2013

First of all, to November 4 Anonymous, you have not yet experienced one of the nice features of the OmniPod---the meter is built in. You do not need a separate meter, and if you use the one built into the pump, the reading is entered automatically. I am confident you will want to use Freestyle strips once you try the built-in meter!
The problem L S is having does not come from the new health care law, but a lot of insurers are reducing the brands of strips or meds or other items they will cover, and I suspect it is just a way for them to try to reduce costs. In some cases I also suspect it results from coziness with certain manufacturers. We have experienced the same kind of inconvenience because of Medicare, which now has issued contracts to a limited number of mail order providers for test strips, most (or maybe all) of which do not handle the Freestyle strips we need for the OmniPod. We now buy strips locally, andI suspect Medicare pays more in the long run. Medicare also will not pay for the OmniPod pump, despite its being FAD-approved and a big improvement in the eyes of many diabetics, purely due to a technicality in their regulations---they say the "pump" is the pod that holds the insulin, and since the pod is discarded every three days the OmniPod does not qualify as durable medical equipment! In other pumps the insulin is in the controller.
I think the consumers need to just scream bloody murder!!! We tend to feel helpless against insurers, and certainly against Medicare, but if enough people complain they might actually listen

Posted by Anonymous on 5 November 2013

You can also check out Freestyle's website at www.myfreestyle.com. They offer a savings program for their test strips. My insurance charges me more for the freestyle strips but with the savings program, I can get the freestyle test strips for the same cost as the ones that are covered by my insurance.

Posted by Anonymous on 5 November 2013

Enlist the help of your Health Care Provider. A letter of necessity and some perseverance may convince your insurance company to make an exception and allow you to get the strips you need.

Posted by Anonymous on 5 November 2013

Every insurance has an appeals process that you can go through, especially with the help of your doctor. Call your insurance and they can inform you of how to go through this process. Then, I would write a letter and have your doctor write a letter as well informing them as to why FreeStyle test strips make sense for you (it's the only strip that works w/ an OmniPod, etc.) Though that process is a bit tedious, it's usually well worth it. Another option is to talk w/ the person in your company who decides what insurance the company provides (this person is typically found in your HR dept) and tell them about the situation. I've found them to be very helpful as well. I'm on an OmniPod as well and it's ridiculous that you would have to use another meter just because those are the only strips they cover. VERY inconvenient to the point of unreasonable. Typically, companies only want to pay for certain strips/insulin because they have a contract w/ the manufacturer of the strips/insulin and get a cut rate w/ that specific brand. I personally have had good results with the appeals process. Good luck.

Posted by Anonymous on 5 November 2013

My daughter uses the OmniPod and we experienced similar issues with our insurance. We were introduced to this company to receive the test strips for the OmniPod. It is through Abbott and called the FreeStyle Promise. Phone 1-855-435-1113. I hope this helps

Posted by Anonymous on 5 November 2013

Pretty sure the president had nothing to do with that.

Posted by Anonymous on 5 November 2013

You also don't have to stay with BCBS; they may want you to think that, but you now have a choice.

Posted by Anonymous on 5 November 2013

Hi, I am sorry you have gotten this upsetting news from your insurance provider...I wonder why you attribute the changes to the president? I have had type 1 diabetes for almost 40 years and have been thru many different insurance companies, and have had favorite doctors no longer covered, favorite brands no longer covered, etc. I blame the insurance companies, not the president. The insurance companies, in my experience, will often pay for a little as they can. Appeal, appeal appeal! Get on the phone and complain, ask what your redress is, and pursue your claim.

Good Luck!

Posted by Anonymous on 5 November 2013

I am current in dispute with my insurance co. Their guidance on their web site said they would pay 80% of diabetes supplies. Their preferred provider did not carry the Abbott Freestyle Freedom Lite meter, so I found another co. on internet and ordered 3 months supplies for about $300. I got back $30. So the contract provider did not carry the meter but they did carry the strips, so I thought I'd better order before they change their minds. This is what happens when you go simply lowest bid, with no exceptions. I think they could say they would pay up to the cost of the meter and strips they do carry and you pay the diff. The providers are not about outcomes, its about profit. Plain and simply. What we hear on TV is just rhetoric hocus pocus.

Posted by Anonymous on 5 November 2013

Are you talking about employer based BC/BS or a Medicare Advantage plan? My husband and I have Anthem BC/BS Medicare. We received the notice about the changes. Ours covers One Touch and Accucheck test strips. Novolog has been dropped and Humalog continued, but they still cover Lantus and Levemir.

Posted by Anonymous on 5 November 2013

From what I understand BCBS will not cover FreeStyle strips no matter where you buy them; even at pharmacies like Walgreens.

Posted by Anonymous on 5 November 2013

I don't think this has anything to do with the Affordable Care Act. I have worked in the diabetes field for many years and every year the insurance companies would change what meters they would cover and which they would not. I also have Blue Cross and use Express Scripts and received a similar letter regarding a medication unrelated to diabetes.

Posted by Anonymous on 5 November 2013

Express Scripts new national formulary is a huge problem. The president of the company claims that the products they decided to stop covering had exact equivalents which we know is not true. It is not just the test strips. He did it with insulin - must use Humalog (not Apidra, not Novolog) even though they are very different. They did it with Victoza and Byette (GLP-1s). They are not the same.

This has been and is a horrendous company to deal with. It has nothing to do with the Affordable Care Act. And we need to 1) get forced mail-order pharmacies mandates done away with 2) forced test strip, insulin and diabetes medications done away with and 3) test strip, insulin, etc. kick backs must be made ILLEGAL.

The ADA, JDRF, etal are not going to advocate on our behalf. It is up to us. Where do we start Diabetes Health?

Posted by Anonymous on 5 November 2013

Every year now, my Part D carrier and Medicare Part D nickel and dime me out of more money. The copay for insulin and insulin needles have doubled. Now Medicare only covers 80% of my diabetic supplies. It use to be 100% What's next.

I would drop ExpressScripts and find a new plan.

Posted by Anonymous on 5 November 2013

Hey, folks...Is it just me, or are we sensing possibly the big, expensive
stock-holder owned insurance companies just further controlling us (as they always have)for the benefit of said stock-holders...and just using the ACA as an EXCUSE?

Just saying...

Posted by Anonymous on 5 November 2013

Why blame the AHA or Obama for something that has been going on for at least 20 years? I've been a type 1 diabetic for 50 years and I can't count how many times our insurance company (we've had several over the years)has suddenly decided they would only cover a particular brand of meter, strips, insulin and other medicines. Sometimes without warning. (One year I had 4 different kinds of generic Synthroid, each time I'd refill the prescription it would be a different, cheaper, generic.) And every year the premiums, deductibles and co-pays have gone way up. The insurance companies have contracts with the various companies that make diabetes supplies, just like they do with doctors and hospitals. It is all about money. When my husband was out of work and had exhausted his COBRA, we tried buying private insurance and were out right rejected by every insurance company. At least that won't happen now.

Posted by Anonymous on 5 November 2013

Nothing good is going to come from Obamacare. I use CCS Medical for pump supplies because Medtronic told me a had to a couple of years ago. I was told about a year ago that I had to switch to a Bayer meter from my One Touch. After I got used to Bayer I was told I had to switch back to One Touch. I was recently told that I have diabetic neuropathy. Express Scripts will not cover the only medication I can use for my Neuropathy. I been a diabetic for over 35 years and things are gradually getting worse. The government would rather see you die than give you the help you need.

Posted by laforĂȘt on 5 November 2013

In Canada, where I live, and in France, where I was born, diabetic needs are totally covered, yes, 100%, insulin, needles, test strips, etc, including doctors and hosptals, and the diabetic patient is free to choose the material he/she likes best, Pumps are free for children, they might not be free for adults, only subsidized. I am not up-to date in this matter.
I learned through your letters the price of insulin, test strips, etc, What a shock !!
simone in Montreal

Posted by Anonymous on 5 November 2013

Every insurance has an appeals process that you can go through, especially with the help of your doctor. Call your insurance and they can inform you of how to go through this process. Then, I would write a letter and have your doctor write a letter as well informing them as to why FreeStyle test strips make sense for you (it's the only strip that works w/ an OmniPod, etc.) Though that process is a bit tedious, it's usually well worth it. Another option is to talk w/ the person in your company who decides what insurance the company provides (this person is typically found in your HR dept) and tell them about the situation. I've found them to be very helpful as well. I'm on an OmniPod as well and it's ridiculous that you would have to use another meter just because those are the only strips they cover. VERY inconvenient to the point of unreasonable. Typically, companies only want to pay for certain strips/insulin because they have a contract w/ the manufacturer of the strips/insulin and get a cut rate w/ that specific brand. I personally have had good results with the appeals process. Good luck.

Posted by Anonymous on 6 November 2013

I have been Type 1 diabetic for 31 years and I am petrified of all the changes coming! I don't think it's right at all for an insurance company to dictate what kind of meter, insulin, syringes, act...that we use. I use the Freestyle lite meter and love it because it's takes the smallest amount of blood. The other meters require you to stab yourself to death just to get enough blood! It's barbaric! I also love the Freestyle beacause you have multiple test sites on the body. I don't know who makes these decisions but I guarantee if they had Diabetes or one of their family memebers then they would want to use what works for them as well. We are already human pin cushions multiple times a day. We should be able to use what we want!

Posted by Anonymous on 6 November 2013

I am forced to use Express Scripts and they "suck" it makes me sick to think that an insurance company has the right to tell us what we can use and not use how much we can use if it's to soon sorry we can't refill that it's to soon. Hang in there with this new health care it might be a bumppy ride. Stay strong and pray for a cure everyday...

Posted by Anonymous on 6 November 2013

I just went to battle with Express Scripts/Medco (it seems that since Medco became part of the picture, things have gotten worse). I use the Cleo 90 9 mm 42" inset with my pump. I received a phone call from ES that they would no longer cover this inset, even though they had the other 5 options (three sizes of 6 mm and the other two of 9 mm). They tried to talk me into other brands, this and that. I stuck to my guns, as did my endocrinologist. The ES pharmacist claimed they didn't National Drug Code for the inset and could I please call Smith Medical to get it since they had not been successful in doing so. Now, let me get this straight. The inset was in your computer system for the last prescription refill and now the NDC number is gone? ES has thousands of employees and no one in the company has access to the NDC number? I did call Smith Medical, had a very pleasant chat with the pharmacist and got the number. It became a matter of principle for me. The end of the story is that after two weeks of phone calls with the ES pharmacist ES finally (gave in?) got the Cleo back in their system and overnighted the prescription to me. Had I been 20 years older and in my dotage or just let myself be intimidated by ES, I would have given up and let them call the shots. I'm afraid it's only going to get worse.

Posted by Anonymous on 6 November 2013

As a physician, I had to weigh in here. These changes have NOTHING to do with the ACA. This is purely a profit driven change by the insurance company (hey, this is America...its all about profit).

Sometimes you can appeal these decisions, sometimes you can't. There are NEW changes with ExpressScripts coming too, which many won't like either. Talk to your provider about your situation, we deal with these insurance issues all the time. My medical assistant has TONS of prior auths every day.

I don't mind using cheaper medications first. I don't mind trying to control out of control costs. I DISLIKE being told what meter is best for my patient.

The ACA is a TOTALLY different issue than issues with Medicare or Medicaid, or private insurance. Let's not muddy up the issue by blaming current events for what has been happening all along.

Unless our insurance companies switch to NON-profit, this will continue.

Posted by Anonymous on 6 November 2013

1. This has NOTHING TO DO WITH OBAMACARE!!!! My insurance has told us what type of insulin to buy and what type of test strips to use for many years!!!! It's private companies making deals with big pharmacies.
2. Any thoughts to the thousands of diabetics who will now be insured thanks to Obamacare? Do you even know what diabetes supplies- any diabetes supplies- cost without insurance???
3. Obamacare is NOT socialized medicine. There are now minimum standards that all health insurance policies must meet. Obamacare is protecting consumers!

Posted by Anonymous on 6 November 2013

THe amount of blood you use depends on how hard you used the penlet. I have been using the One Touch for YEARS and I love it. I don't use alot of blood. I don't squeeze my finger too much so there is less blood. But I don't think it has anything to do with the meter.

Posted by Anonymous on 6 November 2013

It is not the Affordable Care Act making these changes it is the insurance companies. Years ago I was told to switch to a different meter because my supplier was getting rid of the test strips I used. Then when I didn't by advice of my doctor. The supplier just dropped me instead. Profit before health.

Posted by Anonymous on 7 November 2013

I am an RN,CDE,CPT. I have never had a pump patient denied a meter that links to their pump. It just requires a prior authorization from the physician and letter of medical necessity.

Joyce Ellis,RN,CDE,CPT

Posted by Anonymous on 7 November 2013

My husband and I have Blue Cross/Blue Shield, FEP program, and we both got letters that the new glucometer program covers Accuchek Aviva, Nano, One touch ultra 2, one touch ultra mini, verio IQ. We are exempt from express scripts due to having a secondary insurance, Tricare(United Health Care) used to be Blue cross as well.
We are told to call the 1-800 number to choose our new meters and test strips kits Free of charge. I've been using one touch ultra mini for about a year now. I used to use accuchek aviva but had a lot of trouble with inaccuracy.
I use Lantus and humalog, and have had NO letter stating that my Lantus would not be covered. For the most part, Lantus is an "old" formulary drug now. Been around since the 90's. Doesn't make sense they'd drop it for humalog, since Lantus is long acting, versus short acting humalog.

Insurance companies should NOT limit the brand of meter or strips a person uses, due to preference and compliance of the patient. If the patient is comfortable with the meter and is compliant with use and attempts better manage their diabetes the insurance company wins because of lower pay outs in the long run because the patient will hopefully have less complications. This gatekeeping needs to stop. Its looking like it may only get worse for a lot of us.
Trying to find a physician who actually takes an interest in teaching and doing what needs to be done is even tougher.
From my experience, I find that they write the RX and collect their co-pay and say see you in 3 months. Mine doesn't do the proper labs every three months, Renal panel, etc., as needed. I'm lucky to get drawn once a year, but she badgers me every time I do see her to have a pap smear, mammogram and get my eyes checked. Whats the point if I can't even get minimal treatment and labs done. I have thyroid disease as well, but she might check the minimum lab once every 2 years even though I have symptoms more than not. Hair falls out, 10 lb weight gain every year for NO reason, slow gut, depression etc.
I need to find a new physician who will listen and order the appropriate labs on schedule as well as giving me direction for endocrinology. She's lazy and does just enough to get by.
I am grateful for having insurance, but I see a real gap in physicians who really care.

Posted by Anonymous on 7 January 2014

I would like to blame Obama (and the ACA), as he is the problem that allows the insurance companies to do this switching, all of them assuming we're stupid and don't understand. Express Scripts is terrible to deal with. Walmart should take a close look and develop a program that provides the cost efficiencies, plus local pick-up. They could capture the retail customer, sell more from their shelves, and end the lingering questions about when the insulin will arrive and whether the ice packs have melted!

Posted by Anonymous on 13 January 2014

I saw what the insurance company paid for this meter and the idea that they would pay for this machine and NOT want you to use it to it's fullest potential is absurd. It would be like buying a new car with a built in GPS system and then not using it because you can use your old system and plug it into your car/stick it to your window. Why on earth would you do that. We used the company our insurance said to use, the insurance paid for the pump, but they make us pay more for the strips because it's not the meter they contact with - but they didn't even tell us that beforehand. We had to find out when we went to fill the prescriptions. All everybody keeps saying is you can use your old meter and strips, you don't need the ones that go with the Omnipod. It totally blows my mind that they actually think this is a reasonable solution. Our daughter loves the Omnipod so we're not switching; we just pay more every month for our strips.

Posted by Anonymous on 25 March 2014

I work in a doctors office and have so far been on the phone with Express Scripts for 30 minutes trying to find out which meter they cover for a client and am still waiting. So far they have denied both meters. Hooray just got off the phone with still no clear answers. I feel like telling the patient to go to Walmart buy their meter and test strips. I had to pay over $100 dollars for test strips for my insurance provider meter. Got fed up as the cost was so high that I (a nurse) went to the Walmart brand.

Posted by Anonymous on 14 April 2014

I am most annoyed over this issue that all meters and test strips are close and adequate. Some test strips are filtered so they respond only to Glucose D and others read the combined readings of all sugars found in the blood sample.

I am one of those that every time I eat some product with maltose-dextrose, galactose; I will see the meter jump 40 to 100 points off as my digestion system does not fire wall those other sugars from my bloodstream.

The other issue is that as long as your body and its operating characteristics such as water content, oxygen , and hemocratic values are in the normal range and your body does not leak the man made sugars to your blood system, why yes; any meter may be adequate for you.

Some strip technologies reject interferors better than others.

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