Tuesday, July 3, 2007

I hate Blue Cross Blue Shield of NC's State Employees Health Insurance!


YES, I said it...I hate BCBS of NC's State Employees PPO plan. I opted to pay for the most expensive one because I'm a diabetic and I need more health care coverage than most people. The prescription drug coverage that goes along with this plan is absolute crap!

I'm an insulin dependent diabetic (Type 1), and I need test strips, insulin, and needles at my disposal at all times in order to regulate my sugar levels and be a good diabetic. By Thursday of this week, I will be out of test strips. I am only allowed to get 450 during a 90 day period, and I have already reached that max. The next day that I am eligible to get my test strips is on July 17th, fourteen days from today. And if I use their average allotment of test strips during that period, I will need 75 just to make it to the 17th.

Let me explain some of this to you. Test strips are a necessary evil, you have to have them to know what your blood sugar is so that you can give yourself enough insulin to regulate those levels. If you don't have them, you can't check your glucose levels and can't regulate your diabetes. Some diabetics use them only before they eat meals, or just in the morning or evening. If you check every time that you eat, and have a snack between each meal and one before you go to bed, you'd need at least 6 test strips a day to do a decent job taking care of your diabetes. Insurance companies only allot you on average 5 per day in a 30 day cycle.

Unlike most diabetic care items, you can actually buy test strips without a prescription, because how can you use them to harm yourself in any way? You can't. (Unless you're ridiculously stupid and some how prick your finger to test your blood sugar in a way that causes you to bleed like you cut an artery and lose enough blood to kill yourself in the process...or if you start using their sharp little plastic edges to cut your wrist...or you eat them and die of some weird toxic plastic poisoning...in any of those cases the human race should be glad to be rid of such a complete idiot.) However, if you decide to buy these things on your own, without a prescription, and I don't know why you would need them if you couldn't get a prescription for them from your physician, they are only a dollar a piece. Yes, these tiny little strips come in containers of 25 for only $25. That will last you perhaps 5 days if you are careful and your blood sugar miraculously stays regulated with no problems or fluctuations due to stress, exercise, and other outside factors.

Wait! There is a way that this limit on test strips can be overridden. If your doctor contacts your insurance company and gives them prior authorization for going beyond the established allotment, you can get more test strips. No one bothers to mention this to you until you find out that you can't get anymore when you try to refill your prescription at the pharmacy, which people only do when they actually need the prescription filled! When you call to find out how prior authorization works, BCBS tells you that the doctor will need to answer a few questions about your medical condition (meaning if he doesn't say that you are a brittle diabetic, meaning that you could die any moment without excessive help in controlling your condition, then you are screwed because you won't meet their definition of someone who needs more test strips than they think the average diabetic needs) and that this process can take from 7-10 business days to finalize.

Excellent! Not only am I almost assured not to get the prior authorization unless I warn my doctor that I really do need more test strips than they let me have because I'm a good diabetic who likes to check my sugar often and keep on top of it and that I won't sell my extra test strips (which could be lucrative if you could find a buyer and sell them for 50 cents instead of a dollar), but I'm still not going to have any test strips for at least a week and a half, which is the 7 business days, even if they do approve the authorization!

CRAP! CRAP! CRAP! I hate stupid health insurance companies who don't give a damn about their customers true needs! I'm a diabetic who wishes to live a decent life with fairly regulated blood sugars, but go ahead, make my life harder than it is already with a disease that could kill me with just a few missteps in its regulation!

1 comment:

Anonymous said...

Ye I feel your pain.
Ive been type 1 for 25 years now, Im originally from South Africa where I paid more per month for my insurance (as did our employers) but was covered for everything I could want/need (no retarded copays either).
I came to the US and was like "what is a copay?, are you serious?)
I too have seen these types of issues now that I'm on BCBS.

Health care over here due to medical companies does not really seem to be for the benefit of the patients health over all.

Cheers

Sheldon