Tuesday, January 18, 2011

Do you understand the words coming out of my mouth?

We don't check ketones often. Bryce rarely gets them...ok, once when he was throwing up, but that was it. We always just used the urine test strips but through the DOC, I heard about BLOOD ketone testing. At our endo appnt just over 3 months ago, I asked about it. He gave us a meter and some strips. I still have 7 of the 10 test strips. After reading the Reyna's post about blood ketone testing, I decided to call our insurance company to find out if they were covered....

OMG!!! I think insurance companies hire dumb people to field their questions. They never know anything and can't seem to understand whatever it is I am trying to tell them/ask them, etc.
me: "do you cover blood ketone test strips?"
CS: She says she has to look, "yes, test strips are covered with a limit"
me: "what is the limit?"
CS: "well blood glucose test strips have a limit of 200 a month"
me: "ok, but I am not talking about blood GLUCOSE test strips, I am talking about blood KETONE test strips"
CS: "it says you can have two different brands"
me: "well they test different things, are you sure they are part of the same limit?"

No matter how I tried to explain it, she could not seem to understand that a blood glucose test strip and a blood ketone test strip are DIFFERENT things. She finally said she would fax a pre-authorization or something to our doctor. I was about to pull my hair out, so gave up.
A couple days later, I went to the pharmacy to pick up all our prescriptions. Of course, insurance denied the blood ketone strips because I was getting our bg test strips. Ergh, but expected. The gal at the pharmacy said she would call my insurance company and see what she could do. Today she called me back. She told me that she explained the difference in the two tests strips. Found out that the blood ketone strips are not supposed to be covered under pharmacy but under medical (wtf?) but they would allow it this month under the highest copay ($50). I asked how many I get, she said 100. Considering how much I hear they are, I am not complaining, plus we have the Freestyle plan thing where Abbott covers part of the copay (not sure how much but think it is $25) Maybe it was a pharmacist explaining it or maybe it was a somewhat intelligent customer service rep. Regardless, we will be getting blood ketone test strips. We are armed and loaded....may we not need them (much!)


  1. THAT IS FANTASTIC! I know they are really hard to get covered by some insurance companies...which I think is BS...especially for these young type 1 kiddos.

    I hope you don't need them either! xoxo

  2. Cool! We just had our endo appt today and we asked for the same thing - I got a meter with 20 test strips and he wrote me a script for 10 a month, which should be plenty and he said since it's such a low amount, they should cover it. I'm hoping so!

  3. Awesome! Blood ketone strips are like gold around our house. We use them VERY sparingly. Our insurance lets us get them, but fights us every step of the way.

    Careful though, they expire...and the meter REFUSES to let you use the strips once they do. It is VERY frustrating considering how much they cost. So If they are near the expiration date, use them freely! Congrats on getting the perscription!!

  4. Why am I not surprised at the conversation?!~?! Yikers. Good for your for keeping up with the search!

  5. Insurance has never covered them for us. They are $50 for a box of 10 w/o insurance so you got a good deal!:)

    Here's a tip for expiring ketone strips - - - if you have a box that has expired then just change the date on your meter and they will work. Been there - done that and it works great! My endo actually gave us that tip because she gave us 10 boxes of strips that would expire soon. :)

  6. I feel your pain. I tried to talk to our last insurance company about them and I'm not sure why they couldn't figure out how to find them when I told the manufacturer and name...and I could find them on their formulary list. Insurance people are so frustrating!

  7. I am so glad you got some!! THAT is wonderful!! 100 for 50 is fantastic!!! .