Putting Them on Blast

This was a rough week. Not because I miss our baby girl, although I do, and I'm so happy that she's coming back home tomorrow. It wasn't because of my work, because I'm really enjoying my new position. I'm blessed to work with truly talented, funny, thoughtful individuals, and we have lunch together daily, which I love. Every Tuesday, there is ice cream and jazz at HarborPark in back of the courthouse, and we enjoyed that together, too. Next Wednesday, we're going on a staff outing to Plimoth Plantation, our Executive Director will then treat us to lunch and give us the afternoon off. I've also been enjoying playing Words With Friends and Hanging With Friends more regularly because I have the time during my commute, and I've been listening to The Count of Monte Cristo on audiobook. So, no, it's not work.

 So what made this week difficult? Tufts Health Plan. The background to this story is that with Dishon's former job, our family had great health coverage. Co-pays were more than manageable, and we didn't have to pay for things like blood tests, etc. When he left that job, our family was covered under me, but I hated that coverage. Interestingly enough, it was just another version of what we formerly had under Dishon, so I mistakenly thought we'd enjoy the same benefits. Nope. Much higher co-pays and fees for everything! Now, don't get me wrong. I really appreciate that we have health coverage, but it's difficult to go from a really great one to a stressful one. Sheesh. 

Anyway, two years ago, I was diagnosed with type 2 diabetes. Thankfully, we caught it early (I was being monitored since there's a pretty significant family history of diabetes), and it's pretty manageable. I don't have to inject insulin, and I only have to check my blood sugar 2-3 times each week, but I do need to take oral meds, exercise (which I'm SO terrible about - I really need to make time for that), and diet.


When I was first diagnosed, we had Dishon's coverage, and I don't think I even had to pay for my glucose meter, lancer, lancets, or test strips. I noticed recently that my test strips had expired, so I called to ask my doctor for a refill. When I called the pharmacy to find out what the co-pay would be (I've noticed that our meds also have all kinds of funky new prices - some really low, some about $5 more than they were under my coverage, etc.), they told me that it would be $50. This was for the FreeStyle Freedom Lite meter (which I later learned was a tier 3 device, and therefore, more expensive). For those of you who know me well know I love coupons, free shipping, and any kinds of savings, so I really wasn't trying to pay $50 for test strips. I started researching other meters, because apparently, the strips for a meter like Accu-Chek are $20 less (it's a tier 2 device), which is what's up for me. My initial irritation was with the state of Massachusetts. Accu-Chek was offering free meters, but for some reason, they're not able to honor that offer in Massachusetts because of state law. Same with the FreeStyle discount program. Grr . . . 


So I called Tufts about getting another meter, and I was told that Tufts would not cover me getting a meter from a pharmacy. They said I'd have to contact a "contracted durable medical supply provider," and I would have to pay 30% of the cost of the new meter. They provided me with a couple of places to call. One place dropped my call after I explained my situation, and the other said they didn't even sell glucose meters. I called the first place back again (Neighborhood Diabetes Shoppe), and I spoke with a very nice woman who told me that a representative would call me back to help me order the meter, which they never did, even after I went and filled out the contact request online. 


In the meantime, I've been trying to schedule a session with a nutritionist to help me with meal planning, and Harvard Vanguard Medical Associates in Braintree (where my PCP is) has a nutrition department. When I made my appt., I was told that I should call my insurance provider to make sure that a nutrition visit was approved. I did, and the Tufts (THP) rep. told me that although nutrition visits are approved, the nutritionists at HVMA Braintree are not contracted with Tufts, and that I would have to find a different nutritionist. I thought this was odd, since the dept. came up on the list of approved sites on the THP website, but I figured that since she worked for THP, she knew better than I did. This comes up again later . . . 


They sent me a list of contracted nutritionists, and I saw it as an opportunity to see someone close to where I work so I wouldn't have to take too much time off from work to go. I found someone and called my PCP to get a referral to see her. I was called by HVMA's referral specialist and informed that he didn't know what the THP rep. was talking about. My doctor wouldn't refer out to this other nutritionist, because folks with THP coverage regularly see their nutritionists at HVMA, and there's never been a problem with having the visit covered. He said that maybe my THP rep. was new, and didn't really understand how things work, which would make sense, except that I was told that HVMA Braintree wasn't covered by more than one THP rep. So, I'll have to reschedule my appt., because when I was told that HVMA wasn't covered, I cancelled the appt. Again, grrr . . . 


I called THP because I was frustrated about my efforts to get a new meter and to find a nutritionist. I was informed that although the numbers they gave me before didn't result in my getting a new meter, she could give me another list, and I could just keep calling around to find a provider. I asked why I couldn't just get it from CVS, and I was told that they didn't provide medical equipment through pharmacies. I told her what the HVMA referral rep. shared with me, and she agreed that they were on the list of approved sites, but that she didn't see the nutritionists listed as being contracted. She also said that the HVMA rep. seemed to know what he was talking about, however, so I could just go to one of their nutrionists to see if it gets covered. Pardon me, but you would think that the rep. for the insurance provider would be able to tell me ahead of time so I'm not gambling with visits, right? 


Anyway . . . I still have yet to reschedule my visit with the nutritionist, but guess what happened yesterday? I had planned to just go out of pocket and buy the meter on my own when I saw them on sale on Amazon.com for like $20. Turns out I could just buy them out of pocket from CVS, so I planned to do that, and I called my doc for the prescription for the more affordable test strips and lancets. I called CVS to find out how much my prescriptions would cost, and you know what he told me? "We have your meter here. We put it through your insurance, and there's not cost for the meter." I about hit the roof. WHAT??? Seriously?? After all of that, it is covered at CVS? Not just covered, but NO CHARGE?? I'm going to have to stop writing now before I say cruel things, but dang! Right? It shouldn't be this hard! But it's Friday, I have my new meter, and our little girl is coming home tomorrow. All will be right with the world :). Enjoy the weekend, all . . .