Words of warning - everyone please read
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| Thu, 03-18-2004 - 12:37am |
I had a run in with my health insurance company tonight. I have Blue Cross, and I'm on a PPO plan. All of my supplies are covered. Or so I thought. Last month, I got into it with them over my test strips. Basically what I got out of them at that time was that my test strips (for the Freestyle) were considered "brand name", so I would be charged the brand name co-pay. However because of a certain classification, they did not go toward my deductible. This sounded like a load of BS to me, but I went with it.
Tonight, I go to pick up more strips. I expect to pay $30. I was charged $71. I went through the roof. I called the prescription company. They said that it was a policy issue and I needed to call Blue Cross and complain to them. I called Blue Cross, still furious and finally got some answers:
As of 1 March, Blue Cross changed their formulary without warning anyone which drugs/prescriptions would be affected. The Freestyle strips were removed from the formulary, meaning Blue Cross technically no longer covered them, but because they cover "diabetic supplies", I was ONLY charged half-price, not full over the counter cost, despite having a prescription for them. How generous of them.
While speaking with the pharmacy people, I found out that the One Touch strips are in the formulary, as are the Accu-Check. So, either I purchase a new monitor and get my endo to call in a new prescription in a month, or I keep my monitor and allow them to gouge me. I was considering the Ultra Smart (see below), but I didn't want to be forced to purchase one.
If your health insurance covers your supplies, find out if you can speak with someone regarding which supplies are "in the formulary" and which are not and if something may have changed since you last filled something.
A grievance was filed on my behalf. I was the third person the poor girl at Blue Cross spoke to TODAY about the strips as this formulary switch has screwed a lot of people up, and not just us.
I'm in a very bad mood right now. And the day started out so promising. I had been good for the last couple days so I could have a beer tonight, but I missed out because I spent so much time arguing with my insurance company.

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