My niece went to get her test strip and needles and they told her obamacare doesn't cover it anymore

[MattP]

She has type 1 diabetes wtf!!!! I hope she moves back to Ca

[applegrove]

1. ****ers!

[Cha]

2. Is this something the gops took away already? This is terrible!

Is she in a red state now, Matt?

[WillowTree]

3. That just can't be right. Who told her that?

Was it the pharmacy or her insurer?

[MattP]

4. Her doctor told her nothing is covered just asked my sister

Maybe he's a right wing nut job im going to call her right now

[GoCubsGo]

8. Her doctor is a liar.

Either that, or he is grossly misinformed. That's not to say her insurance company doesn't have a hand in it, however.

[WillowTree]

9. Who is her insurer? She needs to call them first thing tomorrow.

'Cause that just cannot be right. Can't.

[LaydeeBug]

13. I would ask her for her doctor's name and call him quickly. If he confirms this

post his name here.

Quickly.

[dixiegrrrrl]

5. See if she can find her medical stuff at this site

goodrx.com

just plugg the name of the strips and needles and it will give a hugely reduced price.

[procon]

6. This isn't in the news; no legislation or WO has been signed.

She needs to call her insurance provider.

[PoindexterOglethorpe]

7. Is her coverage through the ACA?

Surely she has a phone number on whatever card she has that she can call to verify coverage.

I did not think anything had changed as yet, so she needs to find out more as quickly as she can.

Actually, she should politely inform them that she doesn't have "Obamacare",since there is no such thing. And isn't all coverage through the ACA attached to one of the insurance companies, like Blue Cross, or Humana, or whatever?

[WillowTree]

10. Nothing has changed yet.

Either she misunderstood her doctor or the doc just plain doesn't know what she/he is talking about.

[Ms. Toad]

11. Insurance companies are odd about test strips and needles

They can be covered under the RX portion of the plan or under the medical portion of the plan as durable medical equipment (DME) or as diabetic supplies (there may be more, but I'm aware of these three).

Doctors and the two parts of insurance don't necessarily play nicely together - so she'll have to speak with her insurer to determine which part of the plan covers it, since it will be rejected by the other.

Depending on where it is covered, it will likely be subject to copays (Rx) or coinsurance (DME or diabetic supplies) and may not be covered (aside from negotiated discounts) until she reaches her deductible (DME or diabetic supplies)

Every plan should cover it - but how that particular aspect of care is covered varies tremendously.

Good luck - I've spent 9 hours fighting with my insurance company, our Rx coverage, the DME provider, and our benefits coordinator. The only thing that changed for me is that the insurance adminstrator changed - and because of how complex diabetes care is, the correct language in the plan got bolloxed up in translation and each entity was pointing fingers at the other. I've now got supplies for 3 months - but expect to have to go through it again in May or so.

[still_one]

12. She needs to check with her insurance provider what the plan covers in regard to diabetes supplies

and services, including deductibles and co-pays.

Diabetes coverage should include meds, such as insulin, supplies, glucose monitors etc., and supplies should include test strips

You may also need to contact the state exchange. In California it is Covered California

[Massacure]

14. Insurance companies are finicky with test strips and insulin

I've never had issues with lancets or needles, which are relatively cheap. Eli Lilly, Novo Nordisk, and Sanofi-Aventis are the big three insulin manufacturers, and if one of the manufacturers offers an insurer a sweet enough rebate if so many insulin prescriptions are ordered, insurers aren't bashful about not covering insulin from the other two. Humalog (Eli Lilly), Novolog (Novo Nordisk), and Apidra (Sanofi-Aventis) are rapid acting insulins which behave similarly; Lantus (Sanofi) and Levemir (Novo) are long acting insulins which behave similarly. I've never had issue switching between them (I've had to switch insulin every January for the past three years). If I'm not mistaking, Eli just came out with a long acting insulin to compete with Lantus and Levemir, but I cannot think of the name of it off the top of my head.

The same concept applies with test strips. Insurers will put whatever is cheapest on their formulary and not cover other brands.

[Sinistrous]

15. This has nothing to do with "Obamacare".

I am on Medicare and have an excellent secondary insurance, and about 6 months ago, my supplier advised that they would no longer furnish test strips at no cost. There probably is villain here somewhere, but it isn't the ACA.

BTW, I found I can get the test strips slightly cheaper at a local drugstore than I can via my usual mail order vendor.