As diabetics, people with diabetic loved ones, and anyone who has seen a TV commercial starring Wilford Brimley all know, keeping track of one’s blood glucose levels is an important part of staying healthy with diabetes. But what happens when you suddenly can’t get the supplies that you need for the brand of meter that you’ve chosen because your health insurer will only cover one brand of meter?
Some people who get their prescription coverage through ExpressScripts are upset because as of the first of the year, the company will only cover supplies for OneTouch meters. The customers have to buy new meters: that’s the only option. Reader Mike alerted us to this issue, noting the struggle from his point of view in the pharmacy line behind fellow customers taken by surprise.
“I’ve been in line at the pharmacy with many, many angry people, unaware that the change had even been made at the beginning of this year,” Mike writes. “Especially for those on a fixed income, this is an expense they did not need to incur.”
New glucose monitor systems usually have substantial rebates available, since buying a monitor locks the customer into buying that brand’s supplies. Not all consumers know this, though, and not all pharmacies will take the time to walk their customers through choosing a new meter.
We contacted Express Scripts to ask about the change, and they told us that the meter swap was sue to changes to preferred formulary that about 30% of their customers use. “Formulary” is health insurance-speak for “the drugs that we will cover.”
“[I]n the many instances when multiple products are clinically equivalent to one another, we – the nation, its employers, and its patients – are all better off when we choose the more affordable options,” an Express Scripts representative helpfully told Consumerist.
Here’s another helpful piece of information that they gave us: Express Scripts claims that they sent letters out to affected customers telling them about the upcoming mandatory switch, and telling them how and where they could get a new meter for free. Nothing to worry about for people on a fixed income…provided that they paid attention to the mail from their insurance company and their prescription coverage company.