So I’m a Type II diabetic, I take insulin twice a day. The 3-year old insulin monitor I was using is a bit of a pain to deal with, so I talked to my doctor on my last visit about getting a new one. She said that they had some sample monitors and she would just give me one, and write a prescription for the little test strips and needles (“lancets”) that it uses. A week or so ago, I get a call from my pharmacy saying they have to send some insurance (BC/BS by the way) paperwork to my doctor about that prescription. Okay. A little weird, but…okay. Yesterday, I get a letter from Blue Cross telling me that the request for the prescription for the test strips (the TEST STRIPS!! Not even the actual monitor!) was denied because of their “adverse benefit determination.” “According to the information received, the patient’s condition does not meet the medical criteria guidelines established by our clinical pharmacy staff for the proposed treatment.” They go on to say that the “preferred products” for this treatment are “Accu-Chek” or “Ascensia.” I take this to mean that the “Freestyle Lite Test Strips” don’t come with a kick-back to the insurance company like the “preferred products.” They go on to say (and what gall they must have to say this!): “Our pharmacy policy is not meant to dictate to physicians how to practice medicine. Physicians should exercise their medical judgment in providing the care they feel is most appropriate for their patients.” This following a paragraph saying that they aren’t covering a treatment that MY PHYSICIAN HAS PRESCRIBED!!!! This is also supposed to be “confidential communication,” so I probably shouldn’t be sharing it. They don’t want the rest of the world to know what douche-bags they are. So much for the “no-worries, total service “ their commercials all scream about.
Posted on: Thu, 26 Sep 2013 18:12:16 +0000
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