tag:blogger.com,1999:blog-9175362385039466640.post876867514553222511..comments2023-11-07T11:27:28.658-05:00Comments on Diabetesaliciousness © 2007 - 2024: Insulin Pump Supplies & Insurance Companies: Short Changed In Translation~ k2http://www.blogger.com/profile/04167099133092135850noreply@blogger.comBlogger11125tag:blogger.com,1999:blog-9175362385039466640.post-58115486597471557722014-06-21T21:30:08.413-04:002014-06-21T21:30:08.413-04:00I had a similar issue with insulin pens last year....I had a similar issue with insulin pens last year. I need two boxes of Humalog to get me through a month. My prescription dose says 18 units per meal, which mathematically equals exactly enough for one box. I had been greeting two for years, when someone did this math and started giving me one at my pharmacy. Obviously, we all know that he standard dosing does not account for corrections. So my pharmacist (who I love) advised to have my doctor write the perscription to include the standard dosing and indicated for extra insulting as needed to cover for high blood sugar. A simple call to my doctor corrected the issue and I gott my two boxes back. I am wondering if something similar to this would work for you as well?Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-9175362385039466640.post-51658519608595067942014-06-20T09:32:38.117-04:002014-06-20T09:32:38.117-04:00I am a new mom to a teen with type 1. She was dia...I am a new mom to a teen with type 1. She was diagnosed in August '13. It has been difficult for both of us to say the least, but one thing I didn't expect to be so hard was dealing with insurance companies limitations on covering supplies. I figured, "She's diabetic, she needs this stuff to LIVE, they will just give us what we need!" It has not been that easy and it makes me so angry. I have to fight with the insurance company every month about covering her needles (she is still on needles and vials for now). They say we only need 2 boxes a month, but we always run out RIGHT before they will refill them and I have to call and tell them this EVERY MONTH. Last month she broke her bottle of Lantus accidentally. I called figuring, there must be a safeguard in our plan to cover accidents. Nope, I called and spoke to the rep at the insurance company and he said we can't cover a replacement because it isn't in your plan. I was so mad, and hurt but I forked over the $250 because she needed it and after I did that I said, NO THIS ISN'T RIGHT! We pay too much every month to have insurance to cover for things like this. So I called them back and literally threatened to sue them if they did not cover the Lantus. I told them this is not an allergy med, or some pain medication, this is INSULIN, and she will DIE without it. If I didn't have the money to pay for it, she would end up in the hospital costing your more money and then I would sue you and a lawsuit would cost more than covering the medicine. After putting me on hold for A LONG TIME, he finally came back and said they would cover it. I was thankful, but also really angry that I should have to do that at all. I am so disappointed with our insurance companies for not taking care of their most vulnerable patients.Brenda C. Boylanhttps://www.blogger.com/profile/12072352979267533296noreply@blogger.comtag:blogger.com,1999:blog-9175362385039466640.post-55644855677177927182014-06-17T22:27:50.914-04:002014-06-17T22:27:50.914-04:00I made the mistake of not reading one of the many ...I made the mistake of not reading one of the many letters I receive from my insurance company and found out at the last minute that my world had been turned upside down. Effective January 1, I was no longer allowed to get insulin from my local pharmacy, and was forced to use a mail order company selected by United Healthcare - Optum Rx. Sorry, but the only appropriate words are: They both SUCK. Prior to January 1, and for the past 15 years or so, I have received three vials of insulin per month from my local pharmacy. The pharmacy is exactly 1.5 miles from my home, and is conveniently located between my office and my home. The lovely people who work there seem to genuinely CARE about ME. They have been incredibly kind to me for many years, and I have developed a wonderful relationship with them. Now, I receive only five vials of insulin for a three month period. And I receive it via overnight mail, in a huge styrofoam container with three ice packs. It only took me approximately 2-3 hours of phone calls, most of that time spent on hold, to get set up on this glorious new program. They don't care that I am freaking out at the reduced amount of insulin; they don't care that the styrofoam container takes approximately 500 years to decompose; they don't care about the fuel used by the airplane, or ANYTHING ELSE as far as I can tell ... except that it is cheaper for them. It is incredibly discouraging, to say the least.<br />Teresa Borders Wrightnoreply@blogger.comtag:blogger.com,1999:blog-9175362385039466640.post-34013782800607854772014-06-17T20:47:36.008-04:002014-06-17T20:47:36.008-04:00I am lucky that I did not have to switch insurance...I am lucky that I did not have to switch insurance this year. My high-risk pool insurance in Minnesota will continue through the end of 2014. I have noticed no changes in coverage this year. I am very worried about 2015 when I will have to purchase insurance on the MNsure exchange. Sometimes I wonder what they think we do with the excess supplies that they seem to think we are getting. Yes, sometimes we hoard extra supplies. But if we knew that we would always have access to what we need, there would be no need to hoard. Laddiehttps://www.blogger.com/profile/02212090322026085867noreply@blogger.comtag:blogger.com,1999:blog-9175362385039466640.post-56555738157882306872014-06-17T17:07:27.944-04:002014-06-17T17:07:27.944-04:00Hi Kelly... My real issue since January has been w...Hi Kelly... My real issue since January has been with my prescription plan's major change in their formulary list. For those that don't know, everything on the formulary list has cheaper co-pays than similar items not on the list. <br /><br />In my case, it means that instead of paying $60.00 every 3 months for Novolog, I now pay $180.00 every 3 months. Same for my test strips (Accu-View).<br /><br />These changes are more than likely due to the fact that the makers for these (Novo-Nordisk & Roche) couldn't strike the same deal with the provider that they had last year. As a result, the prescription provider now wants to direct me to Humalog insulin and OneTouch meters & strips because they're making a better profit on those items due to the deals they cut with those companies.<br /><br />Sorry for the long comment, but what really bothers me here is the fact that money is the motivator for my provider, rather than people. There will never be a time when that's okay with me.StephenShttp://happy-medium.netnoreply@blogger.comtag:blogger.com,1999:blog-9175362385039466640.post-30421643363844778122014-06-17T16:57:46.100-04:002014-06-17T16:57:46.100-04:00Maybe I'm in the minority here - but my husban...Maybe I'm in the minority here - but my husband and I are paying less per month for insurance this year. We are also paying less per month for my RXs. And despite having issues in the past, I've had zero problems with supply orders this year. They even approved my new Dexcom with no hassles at all.Karihttp://delightfullydiabetic.wordpress.comnoreply@blogger.comtag:blogger.com,1999:blog-9175362385039466640.post-24950392735100968192014-06-17T16:03:32.073-04:002014-06-17T16:03:32.073-04:00Well, welcome to the brave new world of a messed u...Well, welcome to the brave new world of a messed up health care system in transition and going to get worse. <br /><br />My health care insurance last year was great but this year it, well, sucks. My costs across the board have gone up. What I pay for the insurance, the cost of meds, co-pays for doc visits and deductibles. On top of that I have had the same issue with what the insurance company thinks is an adequate supply. <br /><br />To say the least, I'm pissed!<br /><br />I work for an enormous bank, I will call it "the bank for banks" as we handle all the other big banks money. One of my friends works in the HR dept and said that the changes in our health care is directly due to Obamacare and our benefits will be even worse next year. <br /><br />I am now at a point that I have not filled my Lantus prescription as I can't afford the three month supply (which won't last three months) and the insurance company won't bend on allowing me to buy a one month supply. <br /><br />Did I tell you I am pissed? <br /><br />I'll shut up now because what I really need is my last year's insurance and an enormous soap box! Jimhttp://jdbfitz.comnoreply@blogger.comtag:blogger.com,1999:blog-9175362385039466640.post-26292315695545804252014-06-17T15:09:08.621-04:002014-06-17T15:09:08.621-04:00Jenn -
Thanks for your comment! I always get my o...Jenn - <br />Thanks for your comment! I always get my orders filled on a tri monthly basis - I was just a few weeks late getting my 2014 RX filled. <br /><br />Erika - <br />Thanks for your comment! <br />Personally, I've had good luck with Medtronic and terrible issues with my insurance company: <br />http://diabetesaliciousness.blogspot.com/2012/12/horizon-blue-crossblue-shield-blues.html<br />So I'm leaning towards the issue being with Horizon BCBS - But if I hear something different form my C& I you'll red about it in a follow up post. k2https://www.blogger.com/profile/04167099133092135850noreply@blogger.comtag:blogger.com,1999:blog-9175362385039466640.post-32480536366122468892014-06-17T15:08:38.494-04:002014-06-17T15:08:38.494-04:00There isn't enough room to list the issues we&...There isn't enough room to list the issues we've had. Fred's company was bought out in Feb. and we changed insurance. Our old plan was great, but I could see signs of them starting to tighten up. The new plan has been a nightmare since day 1, including trying to even find a company who could fill Elise's pod RX. It was a nightmare and we missed three shipments. I was on the phone with them almost every day for a month. Then we moved onto a fight about her test strips. That one also took a month to figure out.<br /><br />I wish I was as organized and relentless as you. Frankly, I don't have the time for this BS and it exhausts me. You should hire yourself out as some sort of advocate to deal with insurance companies... You'd make a killing!Joannehttps://www.blogger.com/profile/15030783893373288244noreply@blogger.comtag:blogger.com,1999:blog-9175362385039466640.post-68434190498988799202014-06-17T14:57:37.030-04:002014-06-17T14:57:37.030-04:00Prior to August 1st, 2013, I got my supplies from ...Prior to August 1st, 2013, I got my supplies from Medtronic. They told me about the "your insurance says you can only get 3 boxes every 3 mo" problem. However, they did let me know that they could just fill my refill order a month early so that I wouldn't be without supplies and to call them when I had a box left, they wanted to make sure I didn't totally run out.<br /><br />However now my insurance has forced me to get everything (including new devices) through Edgepark and Edgepark says I can get 4 boxes every 3 months if I want to. So I am not totally convinced that it's an insurance problem. Maybe a insurance-contract-with-Medtronic issue.Erika Westphalhttps://www.blogger.com/profile/15367721507592726514noreply@blogger.comtag:blogger.com,1999:blog-9175362385039466640.post-40391715022664295852014-06-17T14:40:59.259-04:002014-06-17T14:40:59.259-04:00After reading this, my last supply order was a dre...After reading this, my last supply order was a dream. I try to refill my supplies every three months, no matter how low I am because I feel more comfortable having no shelf space in my closet than not having enough supplies in case all crap hits the fan. I've always been able to get four boxes of both sits and resevoirs. My last order before the end of my policy year I try to push it to 5 boxes. That gives me a little more wiggle room/time to meet my deductible for the new year. This last order I tried that exact thing. However, I was informed that actually my insurance would only cover 4 and a half boxes every three months. Now I don't know if that has always been the case and my third party supplier thought it silly to open a box so they just sent the whole thing, or if this is a new ruling. Either way, I can guarantee that this next year I will make sure EVERY order is the full amount I can get... available shelf space or no.Jennhttps://www.blogger.com/profile/14726638380884202051noreply@blogger.com