Our benefits didn't change but I get a letter on September 2, telling me that I need to change my network pharmacy.
Yeah, I found that out when I refilled my Celebrex (generic version).
And of course, the network pharmacy name starts with the letters CVS.
I would not have an issue if I was not being told my benefits had not changed. Just admit it and get on with it.
The old insurance limited the amount I paid.
Our prescription costs were managed and limited. We paid so much for each tier of drug. That’s gone now, and I have to pay 20% of the total cost. The good news, is that the major of medications are generic, and some are even free.
Office visits and office procedures were also limited – which reminds me, I need to get my part of the colorguard back, since preventative procedures were free. The preventive costs and procedures are still free. But I also pay 20% of those now.
The good news is that is what we did for a year while I was waiting to go on insurance, so we’ll have to see how that all works out.
So the first part of the savings is to move all of the retired teachers (probably all teachers) in Texas from Express Scripts to CVS/Caremark and I quote, "Your benefits haven't changed".
Really, then why can't I get my Enlight Sensors? Express Scripts was covering them. CVS/Caremark refuses to.
Then I went to refill my Celebrex (generic version). I have been getting a 90 day supply at Tom Thumb Pharmacy (attached to a grocery store). I went to get my prescription this evening and was told they had to fill it as a 30 day supply. I cancelled it, try to call CVS/Caremark and went to a CVS Pharmacy. Guess what, I got to the pharmacy before I got a customer representative.
They were able to fill the 90-day supply and charged $25.00 I don't know what my copay was before.
Our benefits didn't change, but I have to go to Novolog (not a bad thing), and we're told our copays will be different depending on their contracts.
I had a complete pump failure last Sunday. You have to understand that over night on Sunday means Tuesday morning.
With the insurance changes coming up, I had decided to investigate another method of diabetes management.
Now, I have some issues that are probably not going to change. I have some eating issues and I've never been able to be on a schedule. That cuts out 90% of diabetes management method.
In fact, that probably only leaves the pump.
I've had problems with getting too insulin in my system — and I did during the pump failure. I took the choice of dosing every 4 hours. One option I have been thinking of is trying one of the new long acting insulins, but I did not this round. Even with dosing every four hours, I slipped up — I forgot to eat lunch, or didn't even plan for it, and went low doing dog agility. I was able to fix it, but just didn't plan for the whole incident. It is something I should get better at, but it probably won't happen since I've been living this way for decades.
The good news, is that so far, my blood sugar has been good.
Yesterday when I got home from the dog show I went to change everything out. I got a critical failure. The fun part, was that the Medtronic tech on the other end of the phone had no idea what that was, had never heard of that screen, and had to talk with someone else. They were all "shrug", we have to send you a new insulin pump over night.
The definition of overnight, is Tuesday morning.
More fun. My endo is still between offices. Though I did send an email and I think I'll give his wife's office a call again. They are passing the message along. Of course, now we have no history.
Of course, the primary care can't help other than phone in a prescription for long acting insulin but then you have to get that stuff out of your system when you put the pump back on.
So I've got my phone alarm set to go off every 4 hours, I check my blood sugar and give myself an injection based on 2 year old numbers. Of course the current numbers aren't much better.
The call got better — He put the voice message on about returning the pump and he got disconnected. He called me back in the middle of the message, I ignored him and just kept listening. He called me when I tried to call him. I lost it at that point and demanded the supervisor, who was pleasant but of course, "overnight" means Tuesday morning.
Being delivered by UPS who have already lost two insulin pumps and have destroyed uncountable Nordstrom packages.
Last year I went to a diabetes conference sponsored by AstraZenca. At the time I was still using old, faulty, CGMS technology and a service dog.
Yesterday, a social media site posted a picture from that conference with some really nasty comments on the picture. Two different people found me from the picture and let me know.
Here is the thing — if you just bring something like that up to someone without telling them you did something about, yes, you too are cyber bullying. The first posted as a comment to a Facebook public post. The second reached me via messenger and she did say she asked Facebookto pull it.
First, the service dog in question has worked as a diabetes alert dog in my classroom and when I was out in about. She has had only one issue in public and it has been solved. We were at Love Field when a guide dog attacked her. As a result, for a while she would not tolerate other service dogs around us, but we trained and fixed that.
At the conference, she reminded at least one participant that they had forgot to bolus for a meal.
She has flown several times, gone to lots of conferences and teacher training with no issue. I stopped using her when they upgraded my technology to some that works most of the time. I may be losing that technology in January with my insurance. Waiting for the state legislature to stop worrying about bathrooms and to fix real problems like baiting and switching their teacher retirees.
Went to refill my blood sugar test strips. Can't do it on the app, have to call in and get a supervisor to override even though I have pre certification, etc.
Representative told me that while someone else is filling our scripts, our actual formulary, etc won't change until January.
Not holding my breath but that will help.
I'm still waiting for Diabetes of America to come back online, but if that doesn't happen, a new endo practice is opening where my retired endo had his practice.
Still not holding breath.
Man, that was fast. Bill passed last week of May, board meets and passes insurance changes.
On September 1, we move to CVS Caremark. I have already seen their formulary and looks like I may be going back to Novolog. Everything else is generic and will probably have to go though precertification again.
On January 1, we go to a high deductible plan, deductible is $3,000 with an out of pocket max of $7150. Coverage is 80%. Cost is $200 a month. I think I am paying $310 now.
Fun.
Interesting month mystery shopping. I was out of the country the first week. I over scheduled the second week to the point I decided I needed to quit. I still have almost a week and I have over $500 of shops scheduled. Two big money ones, quite a bit of phone and web shops.
A bill passed the Texas State Legislature that is supposed to address the insurance issue. The good news, is that changes won’t come in effect until January 1. We are supposed to get free generic prescriptions – everything is currently generic except insulin.
Back in April, when I was at the Shreveport dog shows, I received a letter telling me that my new diabetes doctor was going out of business the Friday before my next appointment. They said in the meantime see your primary care physician.
Shortly after that appointment was scheduled I received an email that they were opening a new office on June 1. I haven’t heard anything since.
Went through my meds last week, packaging them using PillSuite, and discovered not only was out almost out of my cholesterol medication but that there were no refills. Makes sense, we were supposed to relook all that at the appointment. So I did what they said and made an appointment with my primary care physician.
Saw him yesterday. I went off of statin drugs last year due to statin pain – may still have some vestiges of that – but my labs have slowly been drifting up. So he added generic Crestor, lowest dose. He also said that he was cool with writing scripts for supplies, but couldn’t help with pump dosages. I hope he asked his office assistant if she was cool with it, because he is often cool with something, but she isn’t and it never gets to him.
All good for the next three months.
He did tell me that if Diabetes Center of America didn’t reopen, that there were was an endochronolist office opening soon in their building.