Alissa's Fitness Blog

Alissa's Diabetes and Fitness Blog


Discussion of Diet and Fitness as a tool to manage Diabetes

1.       Reduce Medical Bills: Know your insurance

I made the mistake of misjudging the advanced cost of my medical expenses. As a result, I selected a higher deductible thinking I would meet the deductible right away. 

2.       High Deductible: A financial trap

Recently, I selected Blue Cross/Blue Shield of Texas as my health insurance plan with a $3,750 deductible and $548 monthly premium. After the deductible is met, everything is covered in full without co-pays.  Being I’m on a Dexcom CGM device, I figured I would meet my deductible just from using Dexcom in addition to the expensive cost of insulin.  I made the mistake of NOT checking to see how much the out of pocket cost Dexcom and medical supplies cost before I selected the plan.  I am not going to be even close to meeting my deductible this year, and it has cost me significantly having to pay everything out of pocket.

3.       Errors Happen: Record phone conversations

Ask if the phone conversation is “recorded for quality training purposes” and do not assume insurance companies are “recording phone conversations for training purposes” or accurate notes are being updated in the computer. I’ve encountered several issues with various medical supply companies – from erroneously being told that I didn’t have a deductible (when I knew that I did) to assurances that my supplies would be shipped that week. Thankfully, I had recorded my phone conversations and was able to backup all claims.  However, please check your state laws before recording any conversation. Some states require the other party to consent to being recorded.

4.       Bills: Do not always add up

Although I paid my invoice in full, I was continually billed for the same balance. Thankfully, I had recorded two phone conversations that confirmed my balance was paid. It was only after I presented the tape to the billing department was the error rectified.

5.       Medicine: Not equal

Although my doctor wrote “urgent medical necessity” on my prescriptions and disputed denied claims, BCBS would not approve my medication. The insulin pen that has half-units was not covered. It was incumbent upon me to change to an alternative insulin and revert to “old-fashioned” testing of blood sugar.

6.       Make sure you have enough medical supplies before running out to address any issues you might have getting medical supplies.

Although I’ve never run out of medical supplies before, I have made the mistake of running low on medical supplies and procrastinated before ordering more supplies.  I thought even last minute, I wouldn’t have any issues, but this is not the case.  I advise having enough medication and making sure you order in advance. 

7.       Back Up: Never Run Out

Life sometimes gets in the way, preventing proactive assurance that prescriptions are filled timely and medication is in stock. Cultivate a relationship with the staff in your physician’s office who handles prior authorizations, and will advocate on your behalf to expedite any stalled process. There has been a time or two when my doctor’s assistant provided me with an emergency supply as a back-up.

8.       Speak Up: Advocating Is key

Know exactly what it is you are asking the insurance company and a desired outcome.  Although I spent countless hours on the phone with the insurance company, you have no way of knowing an outcome if you don’t ask. 

9.       Insurance Pharmacist: Is your friend

Ask to speak with a pharmacist though the insurance company.  The pharmacist will provide helpful assistance and discuss alternative options that may be available. 

10.   Shop: A good consumer is an informed consumer
There are stores that cover the cost of medical supplies at a reduced rate such as Walmart or Costco.  You can also order medication through the insurance company and save.  Some insurance companies give you the option of ordering a three-month supply with one month free.  Rebates are available as well. 

Showing 1 Comment

Nirab 7 years ago

I read your blog post and I found it really very useful.
Thanks for sharing your effort with us.

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