venting about weird insurance rules
I have actually probably solved this problem, but am so frustrated
that I want to post about it here to see if anyone else has
encountered it.
On the 27th of Nov. I had my perscription filled for my byetta and
two days later realized that I am getting very low on needles for
the pen. So I tried to have that perscription filled (I have two
refills) and ran into all sorts of problems because there is some
sort of rule that both perscriptions must be filled on the same day
or they won’t give me any needles. It took from Wednesday until
Friday after my doctor’s office was closed to work through this with
medical mutual (three calls to agents and a supervisor callback). I
have to call my doctor’s office and have them fax the perscription
to a durable goods supplier and they will get it for me this time.
My insurance will pay.
What makes me crazy about it is that no one ever told me about this.
I reuse needles to be frugal and not wasteful (it makes very little
monetary difference to me since my copay is low.) Since Byetta comes
in a pen of 60 doses and the needles come in boxes of 100, it is
ridiculous to fill them only together - which I guess I’d done by
fortunate accident the first two times I got needles. One box will
not last two months, but is much more than one month. So is the
insurance company going to waste most of the box each time? Oh, it’s
just so unreasonable. And everyone with a policy like mine is going
to run into the problem at least once. At least I called before I
was really nearly out of needles and can make it to Tuesday when I
SHOULD be getting them from the company.
I can only imagine this has to do with illegal drug use or something
of the sort, but can’t the people who make these rules reason at all?
December 30th, 2005 at 8:46 am
What I want to know…Am I am very naïve about this sort of thing….Is how
)
would some one using drugs use the pen needles? Maybe they just made the
rule for all needles? Any way, I know that was very frustrating. Some of
the procedures that the insurance companies follow are absolutely senseless.
I’m glad that you have gotten it straightened out. And HEY! Lol….if
there gonna pay for the needles…..why not use a new one each time?
(lol….had to say that!
I have actually probably solved this problem, but am so frustrated that I
want to post about it here to see if anyone else has encountered it.
On the 27th of Nov. I had my perscription filled for my byetta and two days
later realized that I am getting very low on needles for the pen. So I tried
to have that perscription filled (I have two
refills) and ran into all sorts of problems because there is some sort of
rule that both perscriptions must be filled on the same day or they won’t
give me any needles. It took from Wednesday until Friday after my doctor’s
office was closed to work through this with medical mutual (three calls to
agents and a supervisor callback). I have to call my doctor’s office and
have them fax the perscription to a durable goods supplier and they will get
it for me this time.
My insurance will pay.
What makes me crazy about it is that no one ever told me about this.
I reuse needles to be frugal and not wasteful (it makes very little monetary
difference to me since my copay is low.) Since Byetta comes in a pen of 60
doses and the needles come in boxes of 100, it is ridiculous to fill them
only together - which I guess I’d done by fortunate accident the first two
times I got needles. One box will not last two months, but is much more than
one month. So is the insurance company going to waste most of the box each
time? Oh, it’s just so unreasonable. And everyone with a policy like mine is
going to run into the problem at least once. At least I called before I was
really nearly out of needles and can make it to Tuesday when I SHOULD be
getting them from the company.
I can only imagine this has to do with illegal drug use or something of the
sort, but can’t the people who make these rules reason at all?
Kristi in Ohio
December 31st, 2005 at 6:56 am
Demetria-Beth - I would have expected no less! You just keep that
thought, there are more than one of us out here!
Elaine (TN)
And HEY! Lol….if
> there gonna pay for the needles…..why not use a new one each time?
December 31st, 2005 at 6:03 pm
Hi Kristi in Ohio & on Medical Mutual
I’m Dee & I’m in Ohio too. With medical mutual and the same deal with the
needles are free if I get them dispensed at the same time as the byetta. The
first few doses I got thru regular pharmacy, and all went well. Then my plan
requires that I get meds thru MedCo in 3 month batchs. Okay, managed that,
but somehow the doc just sent in byetta order, nothing about the pen needles.
So I refilled, and had to pay, at the local pharm.
But I am also on this "special" little feature medical mutual has called
"diabetes care" or something like that. As long as I participate I get my
test
strips and such free. I have to talk to a counselor every 2 months. They
know much less that I and most everyone on her know about managing diabetes,
but I go along for the supplies. We last week I was getting my order
processed, and mentioned the thing about the pen needles, the order guy pipes
up that
he can throw in a couple boxes of them, no prob. !!! Said they don’t even
need a script from my doctor. The 2 boxes of 100 are here 3 days later. I
have enough for a while now, lol. Check and see if your version of medical
mutual offers the Diabetes Care program. They have several special care
programs, such as for asthma, maybe heart, pregnancy, etc.
December 31st, 2005 at 11:14 pm
I can only imagine this has to do with illegal drug use or something
of the sort, but can’t the people who make these rules reason at all?
The pharmacist here in MI told me we don’t need a prescription for needles,
that we can just buy them over the counter. However, my insurance doesn’t
pay anything towards needles and I have to pay for them myself. I was lucky
and got 125 of them (brand new, of course) from Freecycle and I reuse them, so
I’ve only had to buy one box (of 100) since I went on Byetta about 8 months
ago. Janet
January 2nd, 2006 at 4:22 pm
Thanks Dee. So far I have not done this since our version of the
plan supplies all this for free, and I was pretty sure the
counselors would not know more than I do. But if the plan changes
when Paul retires, I may go on this for free supplies. It’s all a
bit ridiculous the way things are administrated.
Kristi