Blue and organization!

Slacking on my Diabetes Month Photo-a-Day posts!

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I may not always wear blue on Fridays (I really try though!) but I always make sure I sport my “Cure Type 1 Diabetes” bracelet! Thanks JDRF!

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My pump supplies cubbie. Don’t worry, I just placed an order today!

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My test strips/extra Rxs/Random D stuff drawer. Anyone want to have a BG testing party?

Sadly, I don’t have a fun spot for my Dexcom supplies.  They just stay in their box in the bottom of my closet.  I feel I need a cute (blue) basket for them!

Not a week goes by….

… without fighting with my insurance company.

Warning: this post is rather venty and may contain some adult language.  Parental Guidance Suggested.

For the past few months I’ve been in one battle after another with my insurance and/or pharmacy benefits company.  Luckily, everything went smoothly with obtaining my insulin pump and CGM.  However, there have been a few headaches that I’ve had to deal with that are really starting to piss me off.  As if we PWDs don’t have enough to deal with, but insurance makes us jump through hoops (of fire, it seems) to get things done.

Test Strips – My blood sugar meter “talks” to my pump.  Yay, Animas!  It’s a One touch meter, not some fancy unique brand that no one has ever heard of.  Well, my strips cost $95/month.  I’ve reached my out-of-pocket max for this benefits year (a perk to making major cyborg-living purchases!) so since they are classified as Durable Medical Equipment, they should be covered 100% for the rest of my benefit year.  Of course they weren’t so I called and was told they aren’t the preferred brand so if I want them covered 100%, I need to switch meters.  Pisses me off.  My pump supplies (remember, my meter “talks” to my pump) are covered, no questions asked.  So, fine.  I’ll switch meters and only use my meter remote when I will need to bolus from it (wearing a dress).  Worth it to save $$ and not a huge deal since I bolus from my Ping 99.7% of the time anyway.  I call to order my new meter (Verio IQ) and they are back ordered/recalled/they don’t like me so they won’t send me one/something.  So, guess who is on her last pack of strips and has to order more at $95 for a month?  THIS GIRL.  I am tempted to call and argue that they should cover this month’s worth of strips since it’s not exactly my fault that I don’t have my new meter yet.  But, I really doubt I’ll win that fight and frankly, I’m tired and don’t even feel like putting forth the effort.
Insulin – Previously, I used Humalog.  Was always covered with no problems.  Well, my doc switched me to  Apidra.  However, when I first got back on pump therapy, my pharmacy didn’t have any Apidra in stock so I used a vial of Humalog that I had to get started.  Worked fabulously.  But, my Endo wanted me to try Apidra so once the vial of Humalog was empty, I switched to it.  I feel like I’m not reacting to it as well as I did with the Humalog, so I asked to be switched back to see if this is the case.  This is all within the last 6 months.  Endo says, no problem, writes me a script for a 90 day supply of Humalog.  I mail it in to my mail order pharmacy and now my pharmacy benefits people are saying it’s not covered.  Something about the “formulary changed”.  Oh, I can get it, I just have to pay out-of-pocket.  So now I have to use a sub-par (for me) insulin because some higher up in some office decided that they weren’t going to cover my insulin.   Granted, it’s not like my control with Apidra is all over the place (if it was I’d be sure to appeal!), but I wanted to see if I’d do better with Humalog, like I think I would.
Dealing with insurance shit makes me rage.  I don’t expect anything to be free, but I’d at least like reasonable options when it comes to my diabetes management.  $1200/year just to test my blood sugar is outrageous.  Telling me what insulin I can and cannot use??  What the French is up with that?!
I don’t often get diabetes burnout.  Sure I’ll have a day here or there where I’m temper-tantruming against the disease.  But, man.  Insurance company burnout?  I have that 24/7.  I just don’t understand why it has to be so hard to make dealing with diabetes or any other chronic illness just a little bit easier with maybe a few more choices so we can make the best decisions for ourselves to manage this disease that we live with every day.
Maybe some day, this will be me.
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Endo Appointment Round Up

Today I had an appointment with my Endo’s Physician’s Assistant.  Honestly, I kinda like him more than my endo (although she’s pretty awesome too!).  He’s young, very thorough, and never seems rushed.  In fact, he spent an hour with me today, which is just unheard of.  Unfortunately I wasn’t due for an A1c test (WAH!) as I had one within the last 3 months.  Kind of a bummer because I wanted to see how my new cyborg life has affected things.  But, I go back in August so I don’t have to wait too long.

We made some adjustments to my evening basal rate so my rates are now:

12 MN – 1.0
8 am – 1.2
2 pm – 1.0
8 pm – 1.6

Insulin to Carb ratios stayed the same:
12 MN – 1:15
7 am – 1:10
11:30 am – 1:9
5:30 pm – 1:9
9:30 pm – 1:15

Insulin sensitivity factor remains at 40 with my goal BG remaining at 120 +/- 10.

So, all in all, decent appointment.  I had emailed my CDE my CGM and Animas reports yesterday and told her about my nephew and that may account for some of the wonky sugars I’ve had over the past week or so.  She asked me when my appointment was and came over today to give me a hug and chat for a few minutes.  So nice.  I am really liking Duke!  My CDE and I have been in pretty close contact since I re-started pumping, I cannot say enough good things about her.  She’s awesome.

I had the PA write me a script for AccuChek test strips and he gave me a present of a shiny new AccuChek Nano.  I’m going to be calling my insurance company to determine exactly what I need to do to get my strips for free now that all of my out-of-pocket expenses have been met.  Hopefully what they told me last month about Accuchek strips being covered 100% is true.  And I have a good supply of one touch strips so should I ever need to use that meter for remote bolusing, I can.

On a personal note, I am muddling through with everything.  Staying busy helps.  My friends and coworkers have been so kind to me and I’m very happy that my sister and her family have such a strong community of friends supporting them.   

You’re not the boss of me!

Argh.  I have a love/hate relationship with insurance.  Love it because w/out it, well, I’d be selling my kidney and firstborn to pay for my diabetes care.  However, that being said, even with insurance, diabetes is expensive, man.

One of the perks for buying my new pump and CGM early on in the year and all at once was that I have met my out-of-pocket max for the year.  Hello, 7 months of lower diabetes costs!  Woohoo!  I called my insurance company to see what exactly was now covered at 100% and was told “all diabetes supplies.”  I clarified with her, “So, pump supplies, CGM sensors, test strips, correct?”.  It was confirmed, yes, these things are covered.  Parrrrrrty!

Imagine my surprise when I went to the pharmacy today and I was asked to pay for my test strips.  Now, this isn’t a $20 co-pay, it’s close to $100 for a one month supply.  The young lady at the pharmacy assured me that they ran it through my insurance/prescription coverage so I paid and told her I’d take it up with them.

I called my insurance company first who connected me with the prescription folks and told me yes, my strips are covered at 100% if I use Accuchek.  I use OneTouch, and they are not covered at 100% under my plan and despite meeting my out-of-pocket expenses, I still have to pay the $100/month.  The way she made it sound was that Accuchek strips are covered 100% all the time, no matter if the out-of-pocket max has been met.

I told her this is ridiculous and she needs to give me the phone number of whomever I need to speak to regarding this.  I have left a voicemail and am looking forward to receiving a call back.  It just makes no sense to me that my pump supplies are covered yet the test strips for the meter that talks to my pump are not.  Does.not.compute.

It makes me pretty angry that some random person gets to decide what is covered and what is not and make decisions about MY medical care.

Wish me luck when dealing with the insurance company!

The cost of the ‘betes.

One of the things that I gripe most about with having diabetes is the sheer cost of the disease.  The doctor’s appointments, the test strips, the glucose tabs, the lancets, the pump supplies, the never-ending prescriptions that always need to be refilled.  It never, ever ends.  I get very frustrated when the Hubs and I are having a budget conversation and we have to include monthly medical expenses.  It shouldn’t be this way.  I feel angry and I feel guilty that my health has such an effect on our finances.

We spend about $300 per month on keeping me alive.  I’m on meds for my thyroid, bum pancreas, birth control (for now), cholesterol, and of course there are the test strips (which my insurance refuses to recognize as a prescription, but instead are labeled durable medical equipment, do not even get me started), pump supplies, CGM supplies, the list goes on and on and on and on some more.  Granted some of these things can be seen as “elective” – Birth Control, Pump, CGM, but in my mind, they are essential.  One of the big reasons why I didn’t go on the CGM previously was the cost.  How sad is that?  I’m on my 10th day with this fancy new toy and I already see it’s amazing value.  My numbers are already better (Currently cruising at 127 and holding steady, thankyouverymuch).  As I said to my husband while venting my frustrations about the “diabetes cover charge”, the insurance companies should be handing insulin pumps and CGMs out like candy.  (Pun intended).  It makes me wonder what costs them more – the initial expense of getting people on these courses of treatment, or treating diabetes related complications down the road.  I know that I am very lucky and very blessed to have insurance and the Hubs and I can afford our out-of-pocket expenses for me to best manage my disease.  As we are planning to have a family, it is so important to both of us that we do whatever is possible to ensure that I am as healthy as possible come baby time!

While I recognize my fortune, I still get frustrated.  I’d love an extra $300 per month to spend on myself (can we say mani/pedi time?) or to put towards our future, be it in a retirement fund or into savings for a new home.  And then when I have the friends complaining that the cost of their birth control went up from $10/month to $20, or that they have to go to the doctor and are annoyed at their copay…it really makes me want to scream.  Medical care is ridiculously expensive as is.  Add a chronic disease in the mix and it just multiplies.  I sometimes think people really have no idea how expensive this disease is.

But, what can you do?  Not taking my meds isn’t an option.  So we grin and bear it and move forward.  It’s just a bitter pill to swallow sometimes, and today is one of those days!