Re: [IPp] Testing only 4 times a day.
> I am new to the list - we are not pumping yet but our pushing for
> it. Even without the pump Elliott tests a minimum of 4 (hardly ever)
> but usually 6-10 depending on how he feels and what activities he is
> in. Insurance wouldn't give me more than 300 strips a month because
> it wasn't "medically necessary". I am still doing battle on that
> one. So if we need additional strips I have to go buy them - not
> cheap. I am saving receipts in hopes to get reimbursed. Good Luck!
That's probably a big OOPS on the part of the insurance company. Get
them to give you the reason in writing :-)
For them to decide something is or is not medically necessary is
called "practicing medicine" which they are not allowed to do. Unless
you are in one of the 4 -- non-diabetes law states, they are required
by law to provide you with diabetes supplies. Nowhere in your policy
of insurance, the "contract of insurance" will you see it writtent
that there is a limit to the number of test strips. This is a pretty
typical stance for an insurance company, but one that can be
"beaten". Ask them to show you where it says in your contract of
insurance that your son can't have what the doctor has prescribed.
They will hem and haw and try to draw you into a discussion of their
"policy", or say it's not allowed but refuse to tell you where.
Simply go through the formality of their appeals process, then file a
formal complaint with the insurance commissioner for your state. I'd
suggest you get the paperwork now as it has the specifics of what you
must comply with prior to filing a complaint.
This is a pain in the butt. I've had to go through it twice in the
last 18 months for Lily, but they always cave in because to do
otherwise will result in sanctions from the insurance commissioner,
then they lose anyway, just big time.
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