5:45am Wake up. TEST (then eat breakfast).
Get ready for work. (Before getting behind the wheel) TEST.
8:30am/9:00am TEST (to make sure my previous amount of insulin worked well). Eat a snack.
11:00am TEST (sometimes) (to make sure my previous amount of insulin worked well). Maybe I eat lunch now.
If I wait until noon to eat TEST.
2:00pm TEST (to make sure my previous insulin worked well, my numbers are ok, etc).
3:30pm I'm usually hungry for a snack. TEST
4:30pm Get ready to leave work. TEST before getting behind the wheel.
Get home anywhere between 4:45pm-6:00pm depending on traffic and picking Derek up from train.
7:00pm TEST before eating.
9:00pm TEST to make sure everything is working ok.
Anywhere between 10:00pm-11:00pm TEST before going to bed.
Occasionally if I wake up in the middle of the night and am interested where my blood sugar is at TEST.
That's 12 BLOOD TESTS...and this is on a day I'm not exercising. You can add another 3 TESTS or so as I TEST more frequently as it gets closer to my actual workout. After my workout. And, if I'm not feeling well, sometimes during my work out.
What about on days I go low. You know the drill: Glucose, juice, etc. Retest in 15 minutes. Still low. Repeat. Same with a high...Take large dose of insulin. Test in 30-60minutes. Keep testing until back in range.
My current Rx allows for 700 strips for a 30 day period.
You can see why I was upset when I received a letter saying I would now only be covered for
no more than 200 strips/30 days.
After calling my health insurance company, the rep confirmed that it was due to the new health care reform. Insurance companies had to reevaluate certain drugs and cut back.
So, apparently the Food and Drug Administration recommends only testing your blood sugar 6 times a day.
Really? And what does the American Diabetes Association recommend?
What about my endocrinologist who is a Diabetes Specialist, M.D., Ph.D., FACP, Professor and Director of the Kovler Diabetes Center out of the University of Chicago?
What does he recommend?
A LOT MORE THAN 6 times a day!!!!
I'm tired of the FDA approving chemicals, hormones, and antibiotics in our food, but putting limits on me and not thinking its a good idea to take care of my Diabetes.
I'm not scamming the system. I'm a hard working American who has always had a job, so I could make money, pay my bills, and yes, because I have Diabetes, unfortunately, health insurance is a big factor in where I work and what I do.
I test a lot, and it's not always fun, but I'm trying to do the best I can to be the healthiest I can.
The good thing is that this doesn't go into affect until April and my doctor can write a letter stating why he thinks it's necessary for me to test more than 6 times a day.
The letter of medical necessity will be reviewed by the Prescription Research Team and they will decide whether or not my full RX will be covered.
The letter that was sent stated I could still order my full RX, but I would then pay out of pocket for anything over 200 strips....that's $500/month!!!
It was an overwhelming day thinking about all of this and day dreaming about the worst case scenario.
I sent a tweet to the White House before getting into bed. I know, it's a long shot.
Jen Enger (sunnyside_life) on Twitter: sunnyside_life Jen Enger
@whitehouse/usg just got denied coverage 4 basic diabetes supplies ive used 4 22yrs due 2 healthcare reform. Thanks a lot!!!
13 hours ago
I started to cry as I lay in bed thinking, "I'm just so tired of Diabetes".
Derek wrapped his arms around me and said, "Oh Jenny, it's ok. The Bears might win it next year."
Of course I laughed, and through my snots and tears said, "I know, but I just figured I'd cry it out for the both of us."
And before he fell asleep, he pulled me in closer and sang, "Ooooh child, things are gonna get easier, oooh child, things will get brighter."
I LOVE MY HUSBAND!
I woke up to an email from my mom with this quote from Tony Evans:
"When God allows trouble in your life, He has a purpose. Dignify your difficulty by finding meaning in the trial."
I know God is BIGGER than the health care system.
All I can do is pray...and enjoy my husband's bedtime serenades!!!!
Get ready for work. (Before getting behind the wheel) TEST.
8:30am/9:00am TEST (to make sure my previous amount of insulin worked well). Eat a snack.
11:00am TEST (sometimes) (to make sure my previous amount of insulin worked well). Maybe I eat lunch now.
If I wait until noon to eat TEST.
2:00pm TEST (to make sure my previous insulin worked well, my numbers are ok, etc).
3:30pm I'm usually hungry for a snack. TEST
4:30pm Get ready to leave work. TEST before getting behind the wheel.
Get home anywhere between 4:45pm-6:00pm depending on traffic and picking Derek up from train.
7:00pm TEST before eating.
9:00pm TEST to make sure everything is working ok.
Anywhere between 10:00pm-11:00pm TEST before going to bed.
Occasionally if I wake up in the middle of the night and am interested where my blood sugar is at TEST.
That's 12 BLOOD TESTS...and this is on a day I'm not exercising. You can add another 3 TESTS or so as I TEST more frequently as it gets closer to my actual workout. After my workout. And, if I'm not feeling well, sometimes during my work out.
What about on days I go low. You know the drill: Glucose, juice, etc. Retest in 15 minutes. Still low. Repeat. Same with a high...Take large dose of insulin. Test in 30-60minutes. Keep testing until back in range.
My current Rx allows for 700 strips for a 30 day period.
You can see why I was upset when I received a letter saying I would now only be covered for
no more than 200 strips/30 days.
After calling my health insurance company, the rep confirmed that it was due to the new health care reform. Insurance companies had to reevaluate certain drugs and cut back.
So, apparently the Food and Drug Administration recommends only testing your blood sugar 6 times a day.
Really? And what does the American Diabetes Association recommend?
What about my endocrinologist who is a Diabetes Specialist, M.D., Ph.D., FACP, Professor and Director of the Kovler Diabetes Center out of the University of Chicago?
What does he recommend?
A LOT MORE THAN 6 times a day!!!!
I'm tired of the FDA approving chemicals, hormones, and antibiotics in our food, but putting limits on me and not thinking its a good idea to take care of my Diabetes.
I'm not scamming the system. I'm a hard working American who has always had a job, so I could make money, pay my bills, and yes, because I have Diabetes, unfortunately, health insurance is a big factor in where I work and what I do.
I test a lot, and it's not always fun, but I'm trying to do the best I can to be the healthiest I can.
The good thing is that this doesn't go into affect until April and my doctor can write a letter stating why he thinks it's necessary for me to test more than 6 times a day.
The letter of medical necessity will be reviewed by the Prescription Research Team and they will decide whether or not my full RX will be covered.
The letter that was sent stated I could still order my full RX, but I would then pay out of pocket for anything over 200 strips....that's $500/month!!!
It was an overwhelming day thinking about all of this and day dreaming about the worst case scenario.
I sent a tweet to the White House before getting into bed. I know, it's a long shot.
Jen Enger (sunnyside_life) on Twitter: sunnyside_life Jen Enger
@whitehouse/usg just got denied coverage 4 basic diabetes supplies ive used 4 22yrs due 2 healthcare reform. Thanks a lot!!!
13 hours ago
I started to cry as I lay in bed thinking, "I'm just so tired of Diabetes".
Derek wrapped his arms around me and said, "Oh Jenny, it's ok. The Bears might win it next year."
Of course I laughed, and through my snots and tears said, "I know, but I just figured I'd cry it out for the both of us."
And before he fell asleep, he pulled me in closer and sang, "Ooooh child, things are gonna get easier, oooh child, things will get brighter."
I LOVE MY HUSBAND!
I woke up to an email from my mom with this quote from Tony Evans:
"When God allows trouble in your life, He has a purpose. Dignify your difficulty by finding meaning in the trial."
I know God is BIGGER than the health care system.
All I can do is pray...and enjoy my husband's bedtime serenades!!!!
Ugh! This is awful. Definitely need to discuss tomorrow evening. I have BCBS too! Derek sounds like a sweetie.
ReplyDeleteAbbey, Definitely glad to meet with you guys tomorrow!!! Sorry to start the meeting off on a downer :( Derek IS such a sweetie. He definitely keeps me laughing! See you tomorrow.
ReplyDeletejen, this is SO awful. i'm so sorry, friend. :( *hugs* p.s. miss you!!
ReplyDeleteJen, let me know if there's anything I can do. I am somewhat familiar with appeals processes. Get your doctor to complete the medical necessity letter/form with as much detail as possible. I'll be praying for you. To be honest, I'm not so sure this really has to do with healthcare reform as much as limiting quantities of certain drugs in an effort to cut costs (they're literally called quantity limits). Through healthcare reform insurance companies and plan sponsors have to provide insurance to more people and so that's going to cost them-- this indirectly affects the rest of the members by the insurance co. possibly raising premiums, copays, or limiting drug spend. As you know, diabetes is a chronic condition and prevention is key to reducing healthcare costs. People don't abuse test strips so applying a quantity limit on test strips that aid in diabetes management is just not very smart. Good luck Jen. Once again, call or text if I can help somehow.
ReplyDeletehow awful ... i also have blue cross blue shield but i'm in ny ... i hope they don't do this to me also! let me know if there's anything i can do to help, i have tons and tons of unopened test strips and i'd be more than happy to send you some!
ReplyDeleteHey Jen, sorry this came your way. I've dealt with that a few times through the years, going back probably for the past decade. I don't see this as a result of HCR, even though the insurance companies blame it specifically because they don't like it. Just like they blame rate increases on the HCR, even though I've watched my rates rise continuously by double digits EVERY YEAR for the past 11. The new law is easy to blame, but it's not necessarily the truth behind the reasoning - or so I've seen. It's all so frustrating. I have found the companies are just trying to cut costs and make sure you actually need what you are ordering. Not that I like it or believe they should be able to do that, as they AREN'T THE DOCTOR. But it is what it is, unfortunately. I've had overrides done on supply limits with a letter from my Endo, and fortunately have't had to go through the appeals process. Good luck on your end.
ReplyDeleteThanks Michael!
ReplyDeleteYes, I've found and heard from a lot of people that the insurance companies are blaming HCR for these hikes in prices, denying/limiting coverage, etc.
It makes me so mad :(
I really appreciate your input. I'm waiting on a letter from my dr.
Thanks again!
This is such a great post! I totally agree with you...I'm currently unable to find a doctor who agrees that I should test more than 4 times a day. I see an endo next month and am sure they'll write the rx for more strips for me. Problem is they want to see me every 3 months and the wait each time is about 4 hours. 4 hours I don't have since I have a hard time getting someone to watch my twins that long. Either way, it's all so unfair. This battle we're in with diabetes supplies and costs is aside from all of the other stuff diabetes throws our way and I find it some of the most frustrating aspects of diabetes. On a happy note, the bedtime serenade story is priceless :)
ReplyDeleteSysy,
ReplyDeleteThanks for commenting.
We can all share in eachother's frustrations! I also see my endo every 3-4 months and yes, I am there for 4 hours in between waiting, seeing him, and getting blood work. That's a lot of sick time I'm using for work!
You are absolutely right...aside from dealing with DIABETES, we have issues of insurance, cost, etc.
But yes, the bedtime serenades and support I get from my husband makes it all bearable!
Ahh, that is frustrating. The company I go through for my supplies seems to only need a prescription from my endo saying I test 10 x a day. Sometimes I test more than that though! I have a couple relatives who are type 2 and don't test nearly as much as I do, so they always give me their extras. It's a crummy situation, but hopefully your dr. can give you some info that may help you out? There's gotta be a way around it--good luck!
ReplyDeleteJen, this is too weird. I read this post 2 days before I got a letter in the mail saying that I was only allowed 600 strips in 90 days also (my script was for 900 in 90 days). It said I could appeal and I was planning on it. Turns out my doctors office already appealed and I've already been denied?!? Who knows if there is anything else that can be done.
ReplyDeleteRight now I'm testing at least 8 times a day, sometimes 10 or more. And why does an insurance company feel that they have the right to tell me how many strips I can use? Isn't that my doctors job? UGH! I'm so over insurance companies!
PS: I'm also using BCBS but mine is out of South Carolina.