Wednesday, November 12, 2008

Bartering Supplies

Anyone who has a chronic illness, has had a major medical problem, or who has to deal with insurance companies on a regular basis will laugh at this post.

Insurance companies are weird in what they decide to pay for and not pay for.

They have argued over and over with us about how many blood GLUCOSE test strips we get a month. We test on average about 11 times a day, which is 330 strips a month. And that's when Emma's not sick. If she's sick, or if she's having a lot of lows, we test more. But they wanted to just pay for 200 strips a month, so I've had to fight and get pre-authorization, and REMIND them that they pre-authorized in order to get enough test strips.

It took me about 3 months to get them to approve the blood KETONE testing strips - something you need to test for when a diabetic is running high numbers. When we first got the prescription, it was denied at Target - they were told it was a "medical" expense and not a "pharmacy" expense. So, I submitted the prescription to the approved medical supply company. It was denied - they were told it was a pharmacy expense. It took lots of phone calls from me AND the nurse from the Doctor's office, and finally my demanding a conference call with the supervisor from the Pharmacy Dept AND the Medical Supply Department where I got them to agree which department would be paying for this prescription and who would be calling to tell the supplier.

So, now I get two boxes a month of the blood KETONE strips - 10 in a box. Only once have I used 10 in a month. Many months I only use 1 or 2 strips. So, I have about 15 unopened boxes.

Someone on the Children With Diabetes message board today indicated that she had drums for the lancet that we use and she need blood GLUCOSE strips. Well, I don't have extra ones of those (because of the story above about arguing between 200 and 350). BUT, I have a TON of the Blood KETONE strips. Many people have trouble getting insurance to cover these strips.

So, I'm sending several boxes of Blood KETONE strips to a member of the board. She is sending blood GLUCOSE strips to the person who has the drums for the lancet. And that person is sending me some of the drums for the lancet that we like to use.

This is a ridiculous game to be played - thanks to a screwed up insurance system. But, as long as insurance is going to be screwed up, we'll figure out how to work the system the way it needs to be worked. I'll get rid of some items that will expire before I have a chance to use them, and get something that I'd like to have extras of. And everyone is happy.


Whitney said...

It's a good thing that you have connections to be able to exchange what you have. Good for all.

Glad to hear things are going well.

Charlotte said...

So glad our 3-way worked out. LOL