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Prescription for test strips? You do the math

Prescription for test strips? You do the math

Why is health insurance so costly? I think part of it may that insurers require a lot of money to develop convoluted and arcane mathematical algorithms to try and squeeze every dollar out their subscribers.

You may recall that, on the advice of my insurer, I switched to a brand-spanking new meter, a Freestyle Insulinx, which has a touch screen and allows me to enter more detailed data, such as insulin doses. The new meter has specific strips, which I got a new prescription for. After some initial confusion at the pharmacy, we determined that I couldn't fill the test strips until I was within the window of being allowed to do a refill. Fair enough.

Well. On June 18, I had picked up a 30-day supply of my old strips. The new script is for a 90-day supply, which I prefer. CVS stocked the new strips (sounds like I am the first person to request them) so that when I finally could get the refill, they'd have em. I called on Friday to fill the script. Yesterday, July 22, I called to see if everything was copacetic before I schlepped over there. You can guess where this is going, right?

The insurer was rejecting the refill because, though it was more than 30 days since I picked up my 30-DAY SUPPLY, filling a 90-day supply was gonna violate some sort of 60-day supply rule. Yes, you read that right.

Now get this, if I chose, I could have gotten another 30-day supply, or even a 60-day supply, just not the 90-day supply.

So I called the insurer, who repeated the whole resupply rule complete with strip quantities (I think she was in training for a job at the Medicare call center).

"So, just how long is my 30-day supply supposed to last?" I asked.

(insert crickets here).

Then she repeated the rule and told me that my doctor would need to call the insurer to tell them this was a new script so that this could then be overrode. Apparently, the new script itself doesn't have that  power.

"How on earth should I have known that?" I asked.

The rep was quick to blame the pharmacy, of course.

I won't print what I said then.

Bottom line, I still don't have the strips for the meter the insurer encouraged me to get.

Meanwhile, in the midst of trying to get this all straightened out, the dr's office called to ask why I hadn't gone to get my bloodwork done for two labs. Thanks to the new insurer, I can no longer use the lab affiliated with MaineHealth (well, I can but it will cost me more). I went to the insurer recommended lab, with the instructions for the draw and which one to test there and which to send to a different lab, complete with address. Apparently, they ignored that part of the letter, (although I think they drew ALL the blood) so I have to go to the MaineHealth lab and have more blood drawn.

Theresa Flaherty
Type 1

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