LifeAfterDx--Diabetes Uncensored

A internet journal from one of the first T1 Diabetics to use continuous glucose monitoring. Copyright 2005, 2006, 2007, 2008, 2009, 2010, 2011, 2012, 2013, 2014

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Location: New Mexico, United States

Hi! I’m William “Lee” Dubois (called either Wil or Lee, depending what part of the internet you’re on). I’m a diabetes columnist and the author of four books about diabetes that have collectively won 16 national and international book awards. (Hey, if you can’t brag about yourself on your own blog, where can you??) I have the great good fortune to pen the edgy Dear Abby-style advice column every Saturday at Diabetes Mine; write the Diabetes Simplified column for dLife; and am one of the ShareCare diabetes experts. My work also appears in Diabetic Living and Diabetes Self-Management magazines. In addition to writing, I’ve spent the last half-dozen years running the diabetes education program for a rural non-profit clinic in the mountains of New Mexico. Don’t worry, I’ll get some rest after the cure. LifeAfterDx is my personal home base, where I get to say what and how I feel about diabetes and… you know… life, free from the red pens of editors (all of whom I adore, of course!).

Tuesday, September 25, 2007

Your insurance cares about you

No really. It’s true. At least that’s what the girl on the phone said. She works for Life Masters. She’s calling to tell me (on my cell, and using up my minutes) that Presbyterian Health plan cares so much about my health as a diabetic that they’ve hired Life Masters to provide me with totally free health advice on the phone.

You know what I told her?

I told her that if Pres really gave a shit about my health they wouldn’t cap me at 100 test strips per month, which only allows me to test three times per day on most days. I told her that, as I’m sure her records show, I’m a Type-1 Diabetic on two kinds of insulin. I should be testing at an absolute minimum of eight times per day to stay healthy; and more times if I feel the need.

If Pres really cared about my health they’d give me the tools that would allow me to take care of myself; instead of spending the money on phone advice.

Now you are probably wondering why I care, three strips per day is what it takes to keep my CGM calibrated. So what’s the problem?

The problem is that CGM, while it has come a loooooooooooong way, isn’t perfect yet. You’d be a fool to put it totally in the driver’s seat. You still need finger sticks for therapy adjustments. How many per day? Depends on how good your control is and how hypo prone you are. Don’t forget that the better your control (which keeps you out of the dialysis center in the long run) the thinner the ice under your feet. D-folk with really good control have more hypos. People with really good control need more strips to maintain that control in safety. CGM is an indispensable tool for me, but I’m not ready to kick my test strips to the curb just yet.

More on test strips. They cost $1 each at retail. There are no generic alternatives. There are no patient assistance programs (well, one company will give you a coupon for 20% off if you are really poor). So that works out to…. eighty cents per strip, times four per day, times 365 days in a year… more than a thousand bucks. That’s well more than most really poor people could afford, even if it were their only out-of-pocket cost for diabetes.

Test strips are universally under-provided by insurance companies, especially for anyone on insulin. The big insurers take a page from Medicare who will only cover ONE STRIP PER DAY for folks on oral meds (including hypo-prone agents like Glipizide) and only THREE STRIPS PER DAY for folks on insulin. I’ve got CGM and I can’t control my diabetes on three strips per day.

Hypocrite alert: yeah, I know I questioned the utility of test strips for patients on orals a while back, but my over-flowing email inbox has convinced me that most patients on orals benefit from testing.

All of this proves that your health insurance really cares about you…. so long as you are one of their shareholders.

6 Comments:

Anonymous Denise said...

You tell them sister. I hate insurance companies. I have an on going fight to get insurance.

7:59 AM  
Blogger Amylia said...

What hypocrites! I hate that! I'm living in Taiwan right now and they have universal health care, but their universal health care covers ONLY insulin for diabetic. It doesn't cover ANY test strips or glucometers or insulin pumps or anything AND they tried to charge me twice for my A1C test b/c they said it was "too soon." AND my diabetes doctor (not an Endo) here is in the money making business. The doctors here open their own clinics to make money then see so many f'in patients that they don't know which end is up. Last time, the doctor confused my A1C with another ladies. He said, "10.2 is too high." I said, 10.2? What are you talking about? Your nurse just said mine was 7.1" He said, Oooh. Yeah. "7.1 Too high!" What a TWERP!!!!!

8:34 AM  
Anonymous Jana said...

LOL...did you really unload all this on the poor woman on the phone? I would have LOVED to hear that. (And I hope she called some one of her superiors and passed the message along.)

But all in all, I completely agree. Big Pharma and the insurance companies should both be ashamed of themselves for how they run the test strip business.

8:38 AM  
Blogger Scott K. Johnson said...

Word up Wil!

8:41 AM  
Blogger Scott said...

I'll bet Life Masters didn't script the rep for your response, but I'm glad someone told them. Half the time, the right hand doesn't know what the left hand is doing at these insurance companies!

1:58 PM  
Blogger cesnh said...

My insurance company has a similar "phone nurse" plan. I'm still pretty new at Diabetes but I still knew more than the caller every single time. It has been a total waste of my time and I no longer answer the phone when they call (I really do love Caller ID). I've also taken the time to write them and let them know that I don't need the calls to remind me to see my doctor, get my eyes checked, have the blood work done, etc..

4:00 PM  

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