It's very nerve wrecking to go to the pharmacy and the prescription for your test strips has been denied - you are only allowed a certain amount of strips, even though you do your blood sugar almost twice as often as the allowable strips!
It's ok - since not all individuals with diabetes need to do their sugar many times per day, the insurers don't just blanket allow a large number of strips to be covered. If you are like me, and have insulin sensitivity, gasteoparesis, lows and highs, you may need more than 8 strips per day.
10 things to do:
1. Plan ahead! Don't request prescriptions at the last minute.
2. Don't freak out! I used to get very upset, and it really doesn't help, but raises your blood sugar.
3. Your doctor or nurse practitioner, or their staff, can appeal the number of strips to the insurance company. Talk to your doctor or nurse practitioner as early on as possible when you realize your coverage issue.
4. Be very clear to your provider about how many times per day you do your blood sugar and why. This will help them when they speak or write to the insurance company. Ex: you have severe lows and do your sugar 12 times per day. Even if the reason is simply because you are type 1, you must be more specific. Help your provider by giving specific reasons.
5. Your office likely knows how to appeal, but the contact number for providers (doctor's offices) are on the back of your insurance card.
6. Follow up with your doctor. If you have an online portal, that's a great way to follow-up and send information.
7. The pharmacy will not know when the appeal has gone through. They will simply just be able to fill a larger quantity. Make sure to say thank you to the pharmacist if you call them 10 times like I do!
8. You may have to have the appeal done every 6 months or 1 year. Again, just breathe in and plan in advance.
9. If the request is denied, you can have the provider try again. Again, use specific reasons why you need more strips, and be honest about your need.
10. Thank your provider. It always helps to be friendly because you will likely ask for a favor again.