The Elusive Green Box

Twelve cents! Why bother?

Twelve cents.

Not want sound ungrateful. But. Some Rx questions arise.

#1: 2013 Bigfoot insurance not cover syringes/needle tips from pharmacy. Must use durable medical equipment supplier. But unable figure out how use durable medical equipment supplier. And since these items not expensive, and only need one time for have on hand in case pump failure, fill Rx at pharmacy.

Today notice BCBSRI chip in twelve cents for syringes. Foolhardy ask why. But why? And thank you.

#2: Bigfoot family insurance plan super-high deductible, amount of deductible loaded on to HSA Visa card for use pay every medical thing until meet deductible. (Pretty neat!) It only February. Close, but not yet meet deductible. So expect pay full cost every Rx, every appointment, etc. So very puzzling why Glucagon (2 sets, $290) come w. copay instead of pay whole thing? And why copay so high? ($60! Last time was $5.)

Yes it is. No it isn't. Yes it is. Maybe it isn't. Maybe it is. We'll get back to you.

Yes it is. No it isn’t. Yes it is. Maybe it isn’t. Maybe it is. We’ll get back to you.

#3: Ketone items arrive with note, “This medication is not covered by your insurance.” Pee strips + blood strips alike. Why this change? Bigfoot call BCBSRI ask why no more cover ketone tools. On hold forever. BSBCRI say CVS wrong, ketone blood strips are covered; pee strips not covered because OTC. CVS say BCBSRI told them blood ketone strips also no covered. BCBSRI then say, “things are denying incorrectly.” (Clever use passive voice!) Then ask, “How many kinds of Lantus does your son use?” and “Do you care if it’s the NovaMax Plus Ketone or the NovaMax Gluc?” and “I bet they’ll put an override on this in research.” These statements not inspire confidence. Then BCBSRI say no claims on Bigfoot file, impossible Bigfoot Spouse pick up items today. And yet. Here these items right before Bigfoot eyes.

Photo1-6

$2.50 a strip and worth it. (But I’d rather pay zero.)

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8 responses to “The Elusive Green Box

  1. Good lord. Bigfoot have incredible patience! We’ve had some of this run-around due to insurance changes in January, but you’re really had some choice exchanges! You’d think the sight of a big hairy beast would give them pause. Maybe visit insurance company in person. ;)

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  2. I may have an answer to your question about the glucagon kits. I also have a HDHP where I pay 100% and then it goes 80/20 after meeting the deductible. However, not all prescription drugs are considered equal to insurance. They put certain drugs on what is called a “preventative drug list”. Then, when you fill these preventative drugs you are charged a co-pay (vs. their full cost). The co-pay does NOT go against your deductible, but it will go against your out-of-pocket max for the year. Again, this may not be the case with your insurance, but it’s very common. As to why the co-pay changed, my only guess is that BCBS up-tiered the glucagon kit to a higher tier than they had it on last year. Again, just one possible answer.

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    • is it because insurers want to encourage us to have glucagon handy, more than they want to encourage us to have the other things?

      i’m not really enjoying untangling this puzzle anymore.

      i think if i waste, what–a hundred or so?–some dollars over the course of the year due to not being able to understand how to do this correctly, that is better than spending any more days on hold, talking to a bunch of kind-hearted bozos.

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      • I work for one of the largest health insurance companies in the country. I’m on the “inside” and still spend HOURS a month on the phone, not to mention THOUSANDS of dollars a year to hit the individual deductible of $1,750.00. Nothing is more defeating than finding out a health insurance company will deny or exclude medications to their own employees. Sadly, some of the worst health insurance benefits are the ones provided to the employees of health insurance companies.

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  3. Sara

    My previous insurance did not cover the NovaMax (or any other brand of ketone strip) at all. Zero. Zilch. I was on the phone call merry-go-round you’ve been experiencing for quite a while to figure that out. The effective date of my new insurance is 3/1/13 so we will see how they feel about ketones soon.

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    • Even the pee kind? Even if you went to get them at one of those specialty stores with the walkers and crutches? (That’s my next stop, if think the $60-$100/year will be worth a trip through the bedside commode aisle.)

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