As a Type II diabetic, I’ve hated the idea and concept of “finger sticks” – pricking my finger with a sharp point, bleeding onto a test strip, then watching as the test strip tells a meter that my blood sugar is too high. Ugh.
Some time ago, my endocrine specialist introduced me to the FreeStyle Libre glucose monitoring system. It’s a sensor that, once attached to your arm, automatically gives you glucose readings for ten days. You simply wave your meter over the sensor, out pops a number and a line graph that shows how your blood sugar has risen and fallen over the hours, easy peasy.
Well, what they don’t tell you about the FreeStyle Libre system is that it’s expensive. And getting a prescription that covers the equipment is very very tricky.
Let me explain.
Every month, I would call my nearby pharmacy in Watervliet and ask them to refill my FreeStyle Libre system. They would have to order it. Then I would enter the store and pay $90 for three 10-day sensors.
This seemed very expensive. And I asked them, “This is covered by my health insurance, right?”
I would get a noncommittal nod, and the pharmacist would motion toward their credit card reader. Pay up.
A couple of months ago, I contacted my health insurance provider. And in the process of discussing my coverage, I asked them, point blank, why the FreeStyle Libre system was so expensive. Shouldn’t my insurance cover this? Aren’t you supposed to cover this?
Then I received a shocking response.
“Mr. Miller, what you have is what we call DME.”
“Durable Medical Equipment. It’s like getting a prescription for a crutch or a walker. And you’ve been paying full price for your FreeStyle Libre system.”
Hang on, hang on – I have a deductible for durable medical equipment, and I sure as hell matched that earlier in January when I had my cataract surgery. So … what’s going on here?
“Well, you can’t get the FreeStyle Libre from a pharmacy. You have to get it from a durable medical equipment provider, and they have to contact us, and your doctor has to contact them, then your doctor has to contact us and then we decide if it’s covered, and then we roll a ten-sided die to see if you have enough hit points to continue … can I give you some durable medical equipment providers that we work with that will cover the FreeStyle Libre system?”
Son of a – you’re telling me that when I thought I was paying for something that was covered by my health insurance provider, that I was paying full price and you were just smiling away?
Easy, Miller …. if your blood pressure goes any higher, you’ll ring a bell and win a kewpie doll.
I took the names of two of the durable medical equipment providers.
I tried the first one. No, we don’t carry the FreeStyle Libre, sorry.
Ding. Here’s a kewpie doll.
I tried the second one. Yes, we can get the FreeStyle Libre, but your insurance provider won’t cover it.
Ding. Here’s a kewpie doll.
And not thirty minutes later, I received a robocall from my health insurance company, asking me if I would like to complete a short survey about the quality of my recent phone call with them.
Ding. Here’s another kewpie doll.
I expressed my concerns to the one person who I thought might be able to help.
That was my endocrinologist.
She was not happy with what she heard. “We need to get you a better setup,” she said.
Ten minutes later, she gave me a phone number for a pharmacy in Albany that not only offers the FreeStyle Libre system, but they offer it at a discount AND they mail it to you at no additional cost. So I don’t have to schlep down to Albany for a special trip every month.
I called that pharmacy in Albany. “Yes, Mr. Miller, we carry the FreeStyle Libre system. And your endocrinologist was kind enough to contact us and we talked and we made sure your health insurance provider is on board.”
“So we can take your address and your credit card information, and everything will be sent to you once a month.”
“That’ll be $70 for your first order.”
Hmm… well, I was paying $90 for full price, now it’s down to $70 … not much of a savings here, but it’s something.
“Actually, Mr. Miller, the company doesn’t make the 10-day sensors any more. They’re now primarily selling 14-day sensors, which are better than the 10-day sensors. You can attach the sensor to your arm, and it goes active in 60 minutes, rather than the 12 hours it takes the other sensors to work.”
And how many sensors do I get for what I pay?
“You get two sensors for a 28-day supply.”
So … two sensors for 14 days apiece, versus three sensors at 10 days apiece. I’m essentially saving $20 in payments, but I’m losing two days of sensor activity?
Yeah. That’s what I thought.
But at this point, I’ll live with it.
I mean, really, what can I do at this point? Go back to pricking my finger and bleeding on a test strip? Or even more radical – going off the reservation and not checking my blood sugar at all?
Nah. I gotta be a good boy and take care of myself.
Look. It’s 2019. I’ve survived cataract surgery. I’ve survived foot surgery. I’ve survived everything else the world has thrown at me.
I can certainly survive this.
Besides, if worse comes to worse…
I still have a lot of kewpie dolls from this experience. 😀