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11 Responses

  1. Nancy
    Nancy December 9, 2012 at 6:58 am | | Reply

    “Medicare guidelines only cover one strip per day for folks on pills and three per day for insulin shooters.”

    So, as a type 2 I’m guessing Medicare does not see the necessity of my using more than one strip per day, although I am on humulin r and lantus as well as metformin? Because they aren’t paying for more than their one box of strips per month, when I need extra it’s out of pocket.

    1. theresa
      theresa December 14, 2012 at 9:07 am | | Reply

      you just contradicted yourself.

      1. Nancy
        Nancy January 5, 2013 at 6:56 am | | Reply

        Not a contradiction, just not clear. I’m one of the people that medicare wants the data that Wil says is for “when a patient uses more strips than Medicare likes to pay for.” So, if I’m using 3 strips per day and they think that’s too much, I’m guessing they think I should be using at the oral med rate of 1 strip per day. During the summer, when I was learning the ropes of short-acting insulin, I was using at least 8 strips per day and everything over 3 was out of pocket. I can sort of predict what my blood sugar will do now but I still think that 3 strips per day is a stupid limit.

    2. nevet
      nevet March 24, 2013 at 2:03 pm | | Reply

      >> nancy: “I still think that 3 strips per day is a stupid limit”

      I couldn’t agree more…it’s actually beyond stupid, totally inexplicable!

      Medicare’s T1 strip limit of 3/day (without onerous and intrusive supporting documentation by caregivers and patients alike) belies having ANY basis or relationship to either consensus medical practice or patient needs!

      Our achieving sufficient control to hopefully ward off dire complications such as amputations, kidney transplants, blindness, dialysis…ad nauseam may rarely involve ONLY 3 pre-meal tests – on a good day – but typically require 4 or 5 per day, and may on a bad day need 6-8 tests due to such common events as verifying a suspect reading, hypo & hyperglycemic events, postprandial testing needs, pre-driving safety checks, during or post exercise checks, cgm calibration tests, and more. A reasonable limit should be stated in terms of tests per month (NOT per day) in order to adequately address the actual ranges involved in per day testing…e.g. 150 strips per month for insulin dependent diabetics.

      While structuring benefits to support the public’s medical need understandably must also address minimizing potentials for ‘waste, fraud and abuse,’ there certainly must be better ways to do the latter than by compromising the main objective and thus greatly risking incurring huge medical costs to the taxpayers for treating increased expensive complications down the road. A prime example of “penny wise, pound foolish!”
      ________________________________

      Wil: So far I’ve been unsuccessful in my efforts to identify who (if any) medical professionals were party to Medicare’s (Congress’s?) structuring of their poorly thought out test strip limits. Do you know or have sources who may be able to answer the question? Also, any thoughts on how we can individually or collectively get this issue addressed and corrected by whoever’s responsible for it? ADA and JDRF type organizations should be leading the effort…but oddly haven’t done so that I’m aware of.

  2. Kitabparast
    Kitabparast December 9, 2012 at 11:38 am | | Reply

    Coincidently, this month’s issue of “Diabetes Forecast” talks about this. See pp. 38-40.

    I still don’t understand, in any case, why insurance providers don’t cover more strips. In my thinking more strips = better awareness = better control = less complications.

    1. Rini
      Rini December 27, 2012 at 5:01 pm | | Reply

      There is a meter out there from Precision, I think it’s the that can do both glucose and keotnes. It is a different strip for keotnes, and if I remember correctly they are pretty expensive. One of those things where if your insurance covers it, it’s probably worth it, but if not you find a way to deal without it…Hope that helps!

  3. Ellen Cooper RN MSN CDE
    Ellen Cooper RN MSN CDE December 13, 2012 at 7:08 am | | Reply

    Insurance fraud regarding test strip acquisition also occurs when patients sell their “excess” strips in classified ads or over the internet, a practice of which I’m sure Medicare is aware. These people make it harder for all the patients who legitimately need more strips.

  4. Ruth Deming
    Ruth Deming December 14, 2012 at 7:09 am | | Reply

    As a type 2, I test 5-6 times a day, and must prove to M/care that I really do. The super-smart people at my chain pharmacy came out with a great solution, tho it creates more work for me, which I did get used to.

    Once a month I must mail in the testing log they sent me, which shows the times of day when I test, plus my readings.

    I also keep my own log, which I show my endo, on which I also record the foods I eat. Right now I’m eating my b’fast, which is a huge salad, b/c it’s the only morning food that doesn’t significantly raise my blood sugar level.

  5. Kelly Rawlings
    Kelly Rawlings December 14, 2012 at 8:28 am | | Reply

    Thanks for addressing the question about Medicare and strips. Because the evidence is mixed on the health benefits of SMBG in non-insulin users (that’s looking at populations–on an individual level, you and your doctor deciding that you need more strips and doing the proper Rx coding and any needed documentation is allowed, but does require an empowered person with diabetes, a dedicated health care provider, and some extra documentation effort as Wil notes). Medicare is going to continue to eye how to cut the vast dollars spent on diabetes–especially dollars that we can’t prove translate to direct health improvement outcomes. Here’s the link to the Diabetes Forecast buyer-beware article that reveals some of the strip fraud issues that contribute to strip costs (and, thus, indirectly, access to strips and to reliable strips) http://www.forecast.diabetes.org/strips-dec2012.

  6. Siegila
    Siegila December 29, 2012 at 2:01 am | | Reply

    I am very disappointed in our Congress the very peolpe who’s main concern is to protect their constituents have failed the American peolpe by passing the heallth care bill without knowing what it actually contains. It is also irresponsible of them to lower medicare fees which are already to low ,it would nice however if the goverment would pay 21.3% of the Doctors overhead expenses.

  7. Mary Miller
    Mary Miller June 9, 2013 at 11:46 am | | Reply

    Thank you Mr. D’Mine for explaining this. I thought it was Obamacare’s rule when my pharmacist asked for a copy of my test log. I gave them a copy, then immediately stopped recording additional information regarding what might have caused too high or too low BS levels. What I eat, when I have insomnia or illness, or run out of insulin – these are between my doctor and me and often involve embarrassing personal failures, so I refuse to share with the pharmacy or government. My doctor wasn’t pleased with the law either.

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