Tuesday, April 12, 2011

A Blue Shield Comparison

It's four months into the year, and I have mixed feelings about our newest insurance plan(Blue Shield/Blue Choice). (previously, we had Blue Cross/Blue Shield)Can't escape them Blues.

- no test strip copay when I went and filled my rx at the local pharmacy..I can't remember the last time THAT happened.(age 21, perhaps)
- 100% coverage on the several emergency magnesium infusions(I have a plan in place for that..it's done at an outpatient infusion center) Is it fun, no, but the nurses there can get blood from a stone(they're very skilled) It also takes about half the time then at an Emergency Room. At $2,000 a pop(if not covered),even under the old insurance the copay was just horrendous. I have standing orders there.(fortunately these days my mag levels are doing pretty well but when things go south,I know it)
-diagnostic tests are covered, 100%. Lab tests appear to be covered 100% as well.

-no mail order pharmacy, I have to order things directly from the manufacturer.And both pump supplies and Dexcom sensors are a chunk of change significantly higher then what I payed under the last plan.
-Test strips I have to get directly from the pharmacy. I miss getting all my D supplies (strips,insulin,pump supplies) in one fell swoop, at the same time, every 3 months.
- Insulin I haven't attempted to get filled yet,but I fully expect Apidra not be covered(Novolog is apparently the med of choice)or some outrageous copay & I will have to go through a lengthy appeal process. I try to use up my vials to the last drop,& therefore go through them pretty slowly but eventually I will have to face the music & go to war with the insurance company. I just don't have the energy/time to do that right now.
-regular drugs (aka synthroid,etc.) are slightly more expensive then they were with the old plan.
-dr office copays are the same...
-ER copays are $100 a pop,about 2x of the old plan. Now I really don't want to go there.(I need a tattoo that says "Do Not Take to ER" on my forehead)If I were to have a bad low, I think I'd want the IV glucose & then refuse transport.(assuming I were in that state of mind) ER's are money suckers.
-I have to get preauthorization on EVERYTHING,which is a pain in the wazoo. Preauthorization can take days, to months.(cannot begin process right before I'm about to run out of something critical)

Bottom line is...most insurance plans have problems, you're always going to be shelling out for something. I'm just glad to have insurance.(that covers as well as it does) I'm not sure yet if I like it better/worse then the old plan..they both have their advantages. I'll probably have more of a opinion later on in the year, when it becomes obvious just how much has been shelled out in comparison to under the old plan.(for mostly the same stuff)

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