Diabetes Talking » Diabetes » prescription plan covering supplies
prescription plan covering supplies
Question:
I actually had to ask the client services about that – they didn’t have that part of the policy published in any of my papers. Hope this helps.
This is a very good point. I learned about this absence of policy information the hard way after my husbands brain surgury. In almost every policy there is an unpublished part addressing rehabilitation and recovery from whatever. You may think you have a policy that covers 100% after a catastrophic ceiling or whatever, but then you have a car accident and need a years rehabilitation and you’ll find there are all sorts of new rules, deductibles, limits etc. The policy you buy and the booklet you get never covers all the information about what you bought and especially what you thought you bought but really didn’t. In our case speech therapy and physical therapy were both argued for months before we forced payment. Even brain mapping after brain surgury was a hard argue. Carol
Response:
Gary, It sounds like you have a prescription card for buying prescriptions. Check out with the pharmacy or ask the insurance directly if you had a prescription for the blood test strips, if that made any difference. Usually you would pay the co-pay when you bought the strips just like any other prescription drug. Richard Hartmann – Hide quoted text — Show quoted text – My job changed insurance plans. Now I have a 15.00 copay for medications, even if they cost less than 15.00. Also, they do not cover supplies since they are over the counter. I’ve been diabetic for 25 yrs and I have never had an insurance company refuse to pay for my accucheck strips and other supplies. Does anyone have any information on an insurance company that will cover supplies for a reasonable price? Most of the supply companies on line bill your insurance and wave the copay, but that excludes me because my policy doesn’t cover the supplies. Thanks.
Response:
and for US to Canada travellers…. GST does not apply to medications and related medical supplies… a lot of the provinces also have a no Provincial tax policy…. for use outside of the province….. Canadians travelling to the US can avoid state taxes on ALL purchases (in a lot of the states) by providing their drivers license to a "knowledgeable cashier"….. or go to another store…. Alberta is the only province without Provincial Sales Tax! — k t1 13 yrs now sending as Tiger Lily ps.. to Gary… GO for IT…. the cashiers should ALL be trained free is best… never pay retail (in bean counter mode…. oops)
– Hide quoted text — Show quoted text – Depending on your state and its policies, you need make sure the cashier doesn’t unknowingly cause you to not get the benefits when buying over the counter supplies without prescription and insurance benefits. In my state, the supplies are sales tax free. But on more than one occassion, I have had fast-fingered cashiers slam the sales tax on them causing the usual delay and frustration while I make them correct their mistake. — | Gary Eheman - eheman at-sign attglobal.net | | Change "invalid" to "net" to reply |
Response:
Depending on your state and its policies, you need make sure the cashier doesn’t unknowingly cause you to not get the benefits when buying over the counter supplies without prescription and insurance benefits. In my state, the supplies are sales tax free. But on more than one occassion, I have had fast-fingered cashiers slam the sales tax on them causing the usual delay and frustration while I make them correct their mistake. — | Gary Eheman - eheman at-sign attglobal.net | | Change "invalid" to "net" to reply |
Response:
Many states have passed laws that require that diabetes supplies are covered. There are many more that have laws "in the works" for this. Check out http://www.diabetes.org/legislation/ for information on your state. If your state does not have a law that requires that all diabetes supplies are covered, don’t give up. Call the customer support number on your card and ask them if the supplies are covered. If all else fails, be sure to talk to the people in your Human Resources department and let them know how much this will effect you. Some times you can use this to negotiate some extra compensation. Good luck to you. — Marilyn Type 1 for 33 years, Minimed pumping for the last 11 – Hide quoted text — Show quoted text – My job changed insurance plans. Now I have a 15.00 copay for medications, even if they cost less than 15.00. Also, they do not cover supplies since they are over the counter. I’ve been diabetic for 25 yrs and I have never had an insurance company refuse to pay for my accucheck strips and other supplies. Does anyone have any information on an insurance company that will cover supplies for a reasonable price? Most of the supply companies on line bill your insurance and wave the copay, but that excludes me because my policy doesn’t cover the supplies. Thanks.
Response:
My job changed insurance plans. Now I have a 15.00 copay for medications, even if they cost less than 15.00. Also, they do not cover supplies since they are over the counter. I’ve been diabetic for 25 yrs and I have never had an insurance company refuse to pay for my accucheck strips and other supplies. Does anyone have any information on an insurance company that will cover supplies for a reasonable price? Most of the supply companies on line bill your insurance and wave the copay, but that excludes me because my policy doesn’t cover the supplies. Thanks.
Response:
My job changed insurance plans. Now I have a 15.00 copay for medications, even if they cost less than 15.00. Also, they do not cover supplies since they are over the counter. I’ve been diabetic for 25 yrs and I have never had an insurance company refuse to pay for my accucheck strips and other supplies. Does anyone have any information on an insurance company that will cover supplies for a reasonable price? Most of the supply companies on line bill your insurance and wave the copay, but that excludes me because my policy doesn’t cover the supplies. Thanks.
Well, if the cost of the prescrition is less than $15, do not claim it. Just pay for it. It is generally less costly to pay for everything yourself than to have the overhead of an insurance company. But that depends on you being healthy. BTW, I think your insurance company is very shortsighted. Jude — Crouch Enterprises – Telecom, Internet & Unix Consulting Oak Park, IL 708-848-0134 URL: http://www.pobox.com/~jcrouch
Response:
My insurance company won’t pay for things I go in and buy over the counter either, BUT with my supplies, if I get a prescription for them, they’re payable. There are now laws in 37 states that make some requirements of insurance companies to cover diabetic supplies. I don’t know the exact URL, but at www.diabetes.org, there is a page in their advocacy section that tells what states. You might also check with the staff at your doctor’s office. They quite often understand the various insurance companies. | My job changed insurance plans. Now I have a 15.00 copay for | medications, even if they cost less than 15.00. Also, they do not | cover supplies since they are over the counter. I’ve been diabetic for | 25 yrs and I have never had an insurance company refuse to pay for my | accucheck strips and other supplies. Does anyone have any information | on an insurance company that will cover supplies for a reasonable | price? Most of the supply companies on line bill your insurance and | wave the copay, but that excludes me because my policy doesn’t cover the | supplies. | Thanks. | |
Response:
Check with them. Call them b/c when I was with Anthem Blue Cross/Blue Shield, you had to pay for them out of your pocket 100%. But then submit the receipt for reimbursement. I actually had to ask the client services about that – they didn’t have that part of the policy published in any of my papers. Hope this helps. – Hide quoted text — Show quoted text – My job changed insurance plans. Now I have a 15.00 copay for medications, even if they cost less than 15.00. Also, they do not cover supplies since they are over the counter. I’ve been diabetic for 25 yrs and I have never had an insurance company refuse to pay for my accucheck strips and other supplies. Does anyone have any information on an insurance company that will cover supplies for a reasonable price? Most of the supply companies on line bill your insurance and wave the copay, but that excludes me because my policy doesn’t cover the supplies. Thanks.
Response:
In most cases, if you have your doctor write a scrip for supplies, the pharmacy will put it through as Rx, and the insurance company will pay – same for insulin. ome pharmacies are willing to write their own scrips for stuff that is OTC (like Insulin or syringes) and put it through. – Hide quoted text — Show quoted text – My job changed insurance plans. Now I have a 15.00 copay for medications, even if they cost less than 15.00. Also, they do not cover supplies since they are over the counter. I’ve been diabetic for 25 yrs and I have never had an insurance company refuse to pay for my accucheck strips and other supplies. Does anyone have any information on an insurance company that will cover supplies for a reasonable price? Most of the supply companies on line bill your insurance and wave the copay, but that excludes me because my policy doesn’t cover the supplies. Thanks.