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RE: [IP] Re: [IPy] Frustrated



One option to get around the insurance game is to buy strips from Amazon.com.
I was uninsured for five months, and was able to buy 100 Contour next strips
for $30 per month

David Jones
freelance journalist
https://davidjones.contently.com
973-485-4153 (phone)
862-763-8304 (mobile)


> Date: Mon, 7 Apr 2014 09:58:37 -0400
> Subject: Re: [IP] Re: [IPy] Frustrated
> From: email @ redacted
> To: email @ redacted
>
> This is good information, not just when dealing with insurance companies,
> but any business transaction, whether it be in person, online or on the
> telephone.
>
>
> On Mon, Apr 7, 2014 at 2:15 AM, <email @ redacted> wrote:
>
> > >  Right now, my endo writes for 8 strips a day, but insurance is saying
> > >  I only
> > > get 200 strips per copay, so I get 25 days worth for one copay. If he
> > > wrote for ten per day, my guess is I'd get 20 days for one copay. I'm
> > > working on this. It's hard to get the people in the endo's office to
> > > understand what needs to be done to get the 30 days supply for one
> > > copay. I already had to switch back to one touch from contour because
> > > of this insurance - which is fine. Minimed supplied them under the old
> > > insurance, and I didn't have to deal with a limit.
> > >
> > > Luckily I have a flexible savings account to help pay for stuff.
> > >
> > > Stacey
> >
> > I've done this over and over for Lily. This is what works every time.
> >
> > Make sure you are talking directly to your insurance company, not the
> > pharmacy supplier. The pharmacy supplier is a 3rd party provider
> > under contract to the insurance co. If they provide you with strips
> > over and above WHAT THEIR CONTRACT WITH YOUR INSURANCE CO. says, the
> > don't get paid so their not gonna do it. You must speak with the
> > pharmacy manager (or some similar title) at your insurance company.
> > The try hard to screen the calls so you can't reach that person but
> > if you persist you will succeed in reaching them.
> >
> > 1) Make sure the doc writes specifically that you are to test 10x per
> > day so that if they don't want to do it then they are "practicing
> > medicine".... and you can ask the question "are you telling me what
> > my medical care should be"? "are you practicing medicine"
> >
> > 2) ask specifically where in YOUR COPY of the contract of insurance
> > it says that strips are limited to (whatever). Make sure you read the
> > section on diabetes supplies so you can quote it back to them with
> > the page number and paragraph number.
> >
> > 3) definetly appeal TWICE. Make sure you document the time and date
> > of each contact and exactly who you speak with. There is no 3rd time.
> > The third time goes directly to the state insurance comissioner with
> > a complaint that your doctor has prescribed specific medical care
> > which is covered by your policy (quote page and paragraph and include
> > a copy) and they have refused to provide the care ... and in addition
> > that they are practicing medicine by countermanding the doctors
> > specific orders.
> >
> > Of course, the third letter will never be written because they will
> > cave in. KEEP the records for each time you have to do this so that
> > you can quote back to them next time, the dates, who you talked to,
> > the dates of appeal, the outcomes, etc.... after a few time, they
> > will probably stop hassling you because they will figure out that you
> > are not an easy mark. I've had to do it 4 or 5 times over the years
> > but it all stopped about a half dozen years ago.
> >
> > Michael
> > .
> > Follow us at https://www.twitter.com/insulinpumpers
> > Make a long URL short at http://type1.org
> .
> Follow us at https://www.twitter.com/insulinpumpers
> Make a long URL short at http://type1.org
.
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