Meter question again
Hello,
I was in Sams Club last night and noticed they have their own meter, the name of
which I forget. The most interesting thing about the meter - price
- the meter itself is, as I recall, around $9.00 and the strips are under $40
per hundred. I test quite often and tend to run low on strips before
my prescription is due for renewal. The price of these strips holds
considerable appeal, but before getting yet another meter thought I’d check and
see if anyone has tried this Sams Club product?
Thanks
November 30th, 2006 at 10:02 pm
> . I test quite often and tend to run low on strips before
>
Roni, couldn’t your dr. write a script for a higher number of strips per
month?
Patrick
December 1st, 2006 at 5:27 am
Roni, couldn’t your dr. write a script for a higher number of strips per
> month?
I think it depens on your insurance company, some set a limit on how many
you cna get per month, I get 250 per month and still run out.
Frank
December 1st, 2006 at 11:41 am
<< see if anyone has tried this Sams Club product?
>>
I wont be any help as I dont go to Sams Club and never heard of it. Sorry.
Anyone else? Chrissy
December 3rd, 2006 at 4:19 am
<< I think it depens on your insurance company, some set a limit on how many
you cna get per month, I get 250 per month and still run out.
>>
Same w/me Frank I only get so many per month. I sometimes test less cause I
cant afford to buy them. They are way expensive. Chrissy
December 3rd, 2006 at 11:51 am
Medicare authorizes 250 a month for me; this is determined by my MD
signing a Medicare form setting the desired amount. I use the 250
almost exactly every month; I suspect I could submit a new form for
more, but so far no need.
Under the new rules, Medicare will also pay for a pump (currently the
508) if you have MD approval and fail the c-peptide test. They pay for
insulin, and all supplies. So I am now in the process of getting
Medicare approval for all this stuff. Big deal for me! This will cut
personal outlay by a significant amount.
David
December 4th, 2006 at 8:58 pm
<< Medicare will also pay for a pump (currently the
508) if you have MD approval and fail the c-peptide test. They pay for >>
Whats a C-Peptide test? Chrissy
December 5th, 2006 at 8:54 am
Chrissy,
If I am remembering correctly a c-peptide test is the one that messures that
amount of insulin that a person is producing if any at all. Chera
December 6th, 2006 at 8:05 am
> . They pay for
> insulin, and all supplies.
David, could you explain how you got them to pay for insulin? In my case they
pay for all the supplies, but not insulin. Usually, medicare doesn’t pay for
meds unless you are in the hospital.
This would be a big help to me, as my insulin "bill" is about $75 a month.
Patrick
December 6th, 2006 at 4:55 pm
It is probably Walmart’s Reli-on brand. They also have their own insulin. If
you have to pay surcharges at Sam’s Club - you don’t at WalMart.
Jan (~_^)
December 7th, 2006 at 1:02 am
BUT, if your doctor Rx’s them how can the ins. co. override that? Are they
practicing medicine legally?
Jan (~_^)
December 7th, 2006 at 5:15 am
Chrissy,
There was a major discussion about c-peptide on this list a few weeks
ago. Basically, it is a test that evaluates whether your pancreas is
working properly, and how well. A type I usually has close to a zero
reading for this test, and Medicare has defined this as the method for
allowing or not allowing the pump.
If you search the internet (try google) and use c-peptide as the search
word, you will find tons of stuff; more than you probably want to know.
David
December 7th, 2006 at 1:23 pm
I have been advised by Minimed that they do pay for the insulin as part
of the pump supply program; but, I am still in the middle of applying
for this upgrade, and the info may be wrong. What you say does make
sense, but since they pay for the pump and all the supplies, one could
define insulin as part of that. Time will tell. I will keep you
posted.
David
December 8th, 2006 at 1:46 pm
Thanks for this info. I have also been working with Minimed, and they
seem to have several different stories depending on the time of day.
I finally found the person at Minimed who is responsible for Medicare
(Molly) but after four calls she does not seem to want to return phone
calls.
I didn’t realize that the c-peptide limit was so low, that a legitimate
type I would actually pass! I just presumed that any type I would
automatically pass.
Maybe we should get enough data to approach our respective congress
representatives and ask them to investigate. If most type I’s are
being rejected because of this low limit, this a first class sham.
When I get time, I will go back and look at the technical data available
and see what most type I people report for this test. This can
establish whether the deal is a phony or not.
David
December 8th, 2006 at 9:54 pm
Take a look at:
This document states that the limit is 0.5 (not .05 as you report), but
also notes that many type I people are not meeting this. So there
seems to be activity in this area.
David
December 9th, 2006 at 6:02 am
The following is from a web site on the c-peptide topic:
"There is little or no c-peptide in blood of type 1 diabetics, and
c-peptide
levels in type 2 diabetics can be reduced or normal. The concentrations
of
c-peptide in non-diabetics are on the order of 0.5-3.0 ng/ml. "
So the report I found and mentioned in the previous post must be
incorrect.
Your number makes more sense. More data needed!
David
December 10th, 2006 at 11:16 pm
<< If I am remembering correctly a c-peptide test is the one that messures
that
amount of insulin that a person is producing if any at all. Chera
>>
Oh OK thanks. After 34 yrs of being diabetic I didnt know that. Chrissy
December 11th, 2006 at 7:24 am
<< If you search the internet (try google) and use c-peptide as the search
word, you will find tons of stuff; more than you probably want to know.
>>
Thanks everyone for your input. It is appreciated. Chrissy
December 13th, 2006 at 1:25 am
That’s ok Chrissy, after 25 years I didn’t know either
fp
December 14th, 2006 at 5:37 am
My previous insurance company had a monthly limit on strips. Their standard
limit
was 100/month, but would do an "override" in the system for up to 250/month but
only by a letter of medical necessity from the doctor. I think how they may get
around the "practicing medicine" question is that they aren’t telling you how
many
strips you can have per month, only how many *they* will *pay* for. If you want
more, you pay. Grrrrrrr!
BTW, I love my current insurance company — they pay 100% of pump and supplies
and
haven’t limited the number or brand of strips (I just pay the non-formulary
co-pay
of $25 vs. the formulary co-pay of $10 — better than paying it all out of my
pocket or using a strip/meter that I dislike). Unfortunately we were informed
by
letter last week that they will no longer be providing coverage in my state as
of
01/01/02. :’-(
Connie…pumping 3 months and loving it!
J Hughey wrote:
December 14th, 2006 at 7:59 pm
Connie,
Does that man your dh’s employer will find new coverage? Can you *crop* your
needs and get as much as you can before 12/31/01 to tide you over? BUMMER!
Jan (~_^)
December 16th, 2006 at 3:05 am
David I would try going through a distributor rather then Minimed Direct,
the distributors seem to work harder for you then Minimed.
December 17th, 2006 at 5:13 pm
Frank,
The only problem I have with a distributor is that Minimed has a staff person
who works full time on Medicare questions. I finally heard back from her
today, but have not got the full story yet. There are so many forms and MD
certifications required that I question that anyone can get coverage without
lots of hassle. As long as Medicare pays the bill, and Minimed can support
the paperwork, I think this is a good approach.
I am more concerned about this c-peptide test limit, and I will be asking
Minimed tomorrow about that. If they deny one on that basis, everything is out
the window and I am back to full service payment! But, like finger sticks, I
am used to that now…..
David
December 18th, 2006 at 10:29 pm
who is your carrier???
My previous insurance company had a monthly limit on strips. Their standard
limit
was 100/month, but would do an "override" in the system for up to 250/month
but
only by a letter of medical necessity from the doctor. I think how they may
get
around the "practicing medicine" question is that they aren’t telling you how
many
strips you can have per month, only how many *they* will *pay* for. If you
want
more, you pay. Grrrrrrr!
BTW, I love my current insurance company — they pay 100% of pump and supplies
and
haven’t limited the number or brand of strips (I just pay the non-formulary
co-pay
of $25 vs. the formulary co-pay of $10 — better than paying it all out of my
pocket or using a strip/meter that I dislike). Unfortunately we were informed
by
letter last week that they will no longer be providing coverage in my state as
of
01/01/02. :’-(
Connie…pumping 3 months and loving it!
J Hughey wrote:
December 19th, 2006 at 6:36 pm
<< BTW, I love my current insurance company — they pay 100% of pump and
supplies and
haven’t limited the number or brand of strips (I just pay the non-formulary
co-pay
of $25 vs. the formulary co-pay of $10 — better than paying it all out of my
pocket or using a strip/meter that I dislike). Unfortunately we were
informed by
letter last week that they will no longer be providing coverage in my state
as of
01/01/02. :’-(
>>
What insurance company is it? Chrissy
December 20th, 2006 at 2:43 am
<< If they deny one on that basis, everything is out the window and I am back
Good luck David. I hope you will get coverage. Chrissy
to full service payment! But, like finger sticks, I am used to that
now…..
>>
December 20th, 2006 at 7:55 am
Keith,
My current insurance is Aetna US Healthcare in Indiana. I know that some people
have
had problems with this particular HMO across the country, but I have been one of
the
lucky ones (knock on wood) so far. My previous insurer was M-Plan. It would be
a good
day when I could come away from the pharmacy with everything I needed without
paying
more than my co-pay. They were a hassle from day one and would only pay 50% of
durable
medical equipment. When enrollment came around last year, I researched the
other
options as thoroughly as I could before committing, especially with regard to
DME/pump.
One thing’s for sure, the longer I live with this disease (3 1/2 yrs now) and
the more I
deal with different insurance companies, the wiser I become. I’m constantly
learning
what questions to ask of prospective insurers.
Connie
Keith Finch wrote:
December 20th, 2006 at 4:03 pm
Chrissy,
Our current insurance is Aetna US Healthcare in Indiana. I hate the thoughts of
having to research another insurance company again so soon. :-p
Connie
December 21st, 2006 at 1:54 pm
Isn’t that the truth. I was fortunate enough to live in California when I was
DX’d and had GREAT insurance. There is enough competition there that many of
the problems have been eliminated. It is against the law to have a pre-existing
medical condition exclusion. I never had to pay a penny for anything. Then I
moved to Illinois and I have had nothing but trouble. The insurance companies
try to not pay until the time limit is up and then the person is stuck with the
bill.
Keith,
My current insurance is Aetna US Healthcare in Indiana. I know that some
people have
had problems with this particular HMO across the country, but I have been one
of the
lucky ones (knock on wood) so far. My previous insurer was M-Plan. It would
be a good
day when I could come away from the pharmacy with everything I needed without
paying
more than my co-pay. They were a hassle from day one and would only pay 50%
of durable
medical equipment. When enrollment came around last year, I researched the
other
options as thoroughly as I could before committing, especially with regard to
DME/pump.
One thing’s for sure, the longer I live with this disease (3 1/2 yrs now) and
the more I
deal with different insurance companies, the wiser I become. I’m constantly
learning
what questions to ask of prospective insurers.
Connie
Keith Finch wrote:
December 22nd, 2006 at 11:37 am
<< Our current insurance is Aetna US Healthcare in Indiana. I hate the
thoughts of
having to research another insurance company again so soon. :-p >>
I hope you find a good one. Changing insurance companies when your happy
w/the one you have has got to be a pain in the butt. Good luck. Chrissy
December 23rd, 2006 at 11:24 am
Matt,
Thanks for your insight on Minimed.
No, I am not about to give up until there is no other way of dealing with them.
They have always been very responsive, but I was always paying the bill. With
Medicare, now I am in new territory, and, as you say, things get rather slow…
David
December 28th, 2006 at 7:41 am
<<No, I am not about to give up until there is no other way of dealing with
them. They have always been very responsive>>
You cna say that again about Minimed, I had to go see my Educator today to
talk about switching back to shots, I had asked Minimed for some samples of
their new set over 2 months ago. I got a card in the mail saying that
because of high demand they could not send me the sets. I called Disetronic
today because someone had mentioned that they have a new set that may help
keep me pumping. They are sending me samples overnight. This is one of the
reason why I would not consider purchasing a pump from Minimed. Minimed
never goes out of the way to help its patiens on the pump but Disetronic
always goes the extra mile.
I have my formula for the Lantus and wil probally start on it in a week or
so.
Frank
December 29th, 2006 at 5:34 am
Frank,
I find your comments re Minimed vs. Disetronic interesting; I have always had
good results working with Minimed (going on 12 years), and have not encountered
the problems you site. In fact, I once had a problems getting sets from the
local distributor (Minimed couldn’t deliver them due to internal problems, the
distributor said) but when I called Minimed directly they sent them the same
day.
I am concerned that the competitive pressures are causing a ‘feature war’
between the pump suppliers. I just went through the Dtron and Htron
specifications carefully, and although they seem to be very impressive, loaded
with goodies, I doubt I would use, or need, many of the new features now
available. In fact, when I was forced to go back to my standby 506 recently, I
found it doing just as good a job as the 507 I have now, except for the square
wave and back light screen. Both I can do without, if necessary. I am not
sure why I am considering upgrading to the 508! What does it really do that I
must have?
The one feature that grabs me, however, is the waterproof specification. If
this really works, it is a real advantage. But again, I have only had one
occurrence in 12 years where it was mandatory, and I figured out a solution.
Their waterproof specification is full of conditional compromises, which all
good specs must do, but if you are to keep it truly waterproof to the
specifications, it requires considerable care with seals, battery, etc. More
things to go wrong, unless one is super careful.
Things that bother me about the Dtron:
The lithium battery is probably harder to get; changing batteries in the 507 is
a pain, but they are ubiquitous.
I personally don’t like the idea of pre filled syringes. This is sure to
limit availability to only one source; also, it appears that you are forced to
use the primer feature, which I would prefer not to have. Much better to do
it before installation; you know what is happening, you can see the results, and
no battery power is required to do the priming.
They make a point that the motor is quiet; doesn’t ‘click’ like the Minimed.
But, I find the ‘click’ reassuring; it tells me that the thing is really
working. I had a motor failure once; it was easy to diagnose: no click!
I guess I still believe in the KISS principle; Keep It Simple, Stupid.
David
January 5th, 2007 at 6:53 pm
I have to agree with you David all these new features are things that most
people do not use or need. The only reason why I need to upgrade is because
the Pump is out of Warranty. I did speak to Minimed about what would happen
if the pump failed, she said they would send me one free of charge till the
new one was approved but I do not want to be up against a wall and be forced
to choose Minimed again.
As far as the water proof specification goes I’m not to crazy about keeping
the pump on in the pool anyway but I can understand the advantages, when you
are on vacation or in a hotel and need to go swimming if I’m by myself I
will not go swimming for fear of putting down my pump and it not being there
when I get back. That Sports Guard is very bulky, but I still don’t trust
going into water with the pump. I would not shower with it on either, I like
being disconnected for an half an hour a day.
> Frank,
January 6th, 2007 at 12:06 am
One of the reasons I love my 508 is the vibration mode. Being legally blind
and severely hearing impaired the vibration is a God send. Before that, I
was much like you Frank did not need all the advancements. I was afraid of
having to go off the pump, but with the vibrating it is a breeze.
Gail
January 6th, 2007 at 8:39 am
Frank,
I am in a similar situation; the warranty expires in November, so I have some
time to deal with it.
As far as the waterproofing is concerned, I used the sports guard once, when I
was on an all day trip in a rubber boat, and it worked fine. Bulky, though.
Never leaked.
I don’t mind disconnecting for even up to an hour if my Bg is normal at the
beginning.
David
January 6th, 2007 at 4:46 pm
Good point, Gail!
Sometimes we forget that others have additional problems that we ignore….
David
January 7th, 2007 at 4:49 am
Whatever floats your boat.
I’m glad we have choices and aren’t still stuck
with one basal rate and whole units only delivered. (~_^)
January 7th, 2007 at 8:37 am
Is that a real saying or did you just make it up?
Gail
>Whatever floats your boat.
January 7th, 2007 at 9:04 pm
I plagiarize most of what I say - especially if it’s significant. (~_^)
~A. Non. Emouse ~
January 8th, 2007 at 1:53 am
<< Is that a real saying or did you just make it up?
Gail >>
Its really a saying. Chrissy
January 26th, 2007 at 2:27 pm
David,
First, sorry so long to respond. Double check your information.
Unless something major has happened in the 3 weeks I’ve been on short
term disability, Medicare will pay for a 506 not a 508…they only
authorize the previous model (I think it’s a cost-cutting thing). Of
course with the approval of the Paradigm, maybe the 508 is the
previous model now? ! I actually hope you’re right and I’m wrong!
That would be a big step forward in gov’t med policy, and a further
step forward for private insurance! {Since once the gov’t decides to
definitely cover something, private industry has to improve their
coverage…don’t understand why, but that’s the way it works!)
January 26th, 2007 at 10:35 pm
The process involved is a medical necessity issue…the doctor will
have to appeal the insurance decision, and provide treatment notes
and ‘proof’ that you require the more frequent testing. Keeping them
on hand for emergencies doesn’t count. Of course even if you get the
higher amount authorized through this route, they can audit your
pharmacy records, and if you go longer than 30 days between
purchases, they can change it back. Its the same as if you need to
get a refill before your script should have run out. Big Brother
mentality at its finest! LOL! Basically though, IF they cover the
strips, and you can prove that you must have them, they cannot refuse
to pay for them. They can refuse to give you more than the alloted
amount (say 250) at one time though, which means you pay
your "monthly" co-pay 2 or more times a month. They also do this
with antibiotics…even though the doctor requires 2 rounds (say 14
days) they can refuse to cover more than 7 days at a time.
Suzana
January 27th, 2007 at 8:35 am
Suzanna,
I stand on my previous statement…
It came directly from the Minimed specialist at their home office (Molly Gordon.
The 508 they supply is refurbished. I have no idea if the Paradigm has been
approved yet; I tend to think not.
But, if you already have a pump (504, 506, 507, doesn’t matter; Medicare will
not approve a pump! They consider that since you already have one, you don’t
need another, regardless of the model. So, I am out of luck due to that (I am
on my 3rd pump at this point).
So I am looking at springing for a 508 out of my own pocket, and then getting
the free upgrade to the Paradigm later. At this point, I am not sure I want
the Paradigm; not enough capacity. When U200 insulin comes on the market, that
will change my attitude.
I would suggest that you call Molly Gordon, Medicare Specialist, (x5364) and
get her opinion directly….
David
January 27th, 2007 at 4:42 pm
Very true, but in practice it works just fine.
I have been receiving 250 per month for five years now, and have never had a
problem. Medicare always has paid, and the Medigap has always paid the rest.
I get stung occasionally in January due to the $100 deductible being declined,
as the Medigap does not pay for non preferred providers; the moral here is to
always see an MD in early January (be sure NO other Medicare charges appear
before that) who qualifies, and make sure they charge at least $100! Rules,
Rules Rules…..
David
January 30th, 2007 at 7:52 am
Hey David,
I agree…you’ve got your information! I just went through about 300
posts…so when I wrote my response I hadn’t seen all the others!
Oops!
I too would be amazed if the Paradigm has been upgraded the
the "current" model yet! When I left the office last month, medicare
would only cover the 507 (506 was a typo)…I’m sure that due to
supply issues the refurbished 508 is the new standard…I just had no
access to that information. Which is why they won’t cover upgrades.
It stinks! I know that for new pumpers who qualify at least they
have an option to pump…but noone should be restricted to
a "previous" model standard like this policy basically does. Of
course many private insurances still refuse to pay for an upgrade if
the current pump is working, but most will consider an upgrade once
the warranty runs out. Unfortunately like everything else the gov’t
programs run behind the private industry.
Getting a pump through Medicare is a perfect example of too much red
tape and regulation, the process needs improving, but the guidance
and control isn’t there to do so very quickly.
One question, did you actually get a denial from your Medicare
carrier (a hard copy)? You should have. I’d be curious to see
exactly what they use as the denial reason. It might also be helpful
for us to reference when we start sending letters to Congress
demanding Medicare improvement.
Suzanna
February 6th, 2007 at 3:37 pm
Have you checked to see if your Medigap insurance will cover a new pump?
Patrick
February 7th, 2007 at 8:56 pm
Suzanna,
I am in the process of getting the ‘denial’ from Medicare. I expect the reason
to be that I already have a pump; if it isn’t then I have learned something new!
Once I get the denial, then I qualify for supplies.
Then, I may go for the 508 on a private deal.
Not sure why I really need a 508; the 507 works just fine, but the warranty
expires in November.
David
February 8th, 2007 at 5:39 am
<< So I am looking at springing for a 508 out of my own pocket, and then
getting the free upgrade to the Paradigm later >>
Arent they like $4000? Chrissy
February 8th, 2007 at 9:19 pm
Partick,
No, I have not checked with Medigap, but I already know the answer…NO NO NO.
David
February 9th, 2007 at 5:26 am
Yes, but I get a discount!
They are giving me a trade in allowance.
David
February 9th, 2007 at 2:10 pm
<< Yes, but I get a discount!
They are giving me a trade in allowance.
>>
Thank goodness. Chrissy
February 10th, 2007 at 5:52 pm
Are you sure they aren’t $5,000 ($4,995) before discounts?
Jan