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[IP] RX Problems

Hi Tina,


I was just reading your message below and felt the need to respond.  I have
had the exact same problem with my pharmacy.  My coverage affords a 30 day
supply; they come up with this simply by multiplying your prescribed dosage
by 30.  If there's no dosage prescribed, they give you a minimum amount.
I had a problem with humalog pens (before my pump) and also with test
strips.  With carb counting, I had no idea how much insulin I would consume.
I usually went through 2 boxes per month.  I went in one time and was only
given 1 to last a month.  Since I had no prescribed dosage, I was only
getting 1 box.  I ended up going back to my doctor and asked for a higher
prescribed dosage for the prescription.  For my test strips, I am prescribed
to test 12 times a day; this gives me a supply of 400 strips.  For my
humalog, I calculated and determined that a prescription for 100 units per
day would give me enough to last a month.  I know it's frustrating but
usually if you explain the situation to your doctor, they will do what you
need to get by.  


Hope this helps !



DX 1998, pump for 1 month, MiniMed Paradigm.



Date: Mon, 24 Feb 2003 10:42:03 -0800

From: "TINA ROBERTSON" <email @ redacted>

Subject: [IP] insurance


I know we have been over this topic so many times in the recent past and

I appologize for bringing it up again, but I just don't remember the

particulars, now that I need the facts.


I just got insurance coverage the begining of Feb, then it took over 2

1/2 weeks to get my cards so I could start using the services.  Well to

make a long story short, I went to the pharmacy this weekend to get my

perscription for test strips, I was told when I got there (after work on

Friday night) that my insurance only covers 100 of the 300+ I use and the

perscription was written for.  The Insurance Co. tried to tell me that it

didn't matter what the Doctor wanted or thought I needed, that they, the

Insurance Co and my employer, had the final say so on what and how much

was covered.  If I wanted or needed more than what they allowed, I would

have to pay out of pocket.  It didn't matter that I told them I test 10+

times per day.  I may note that neither the Insurance Co nor my employer

are licensed to practice medicine nor are they Endos.


Now I know this isn't right and I know they are trying to pull a fast

one, but I just don't remember enough of what has been said before to use

as a rebuttal.  This is the first time I have had this particuilar

problem with any insurance co.


H E L P !!!!!!!!


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