Once you get out of the usual range of medicines and healthcare products that your supermarket pharmacy offers, you are in for an adventure that will enrage and confuse you for many weeks at a time. I am sure this has to do with the fact that these products are relatively new to the market and your insurance company is not up to speed on them. This particular adventure has to do with a new set of products for use by diabetics, but I have reason to believe that this kind of problem may exist for all kinds of newer medical supplies.
There are new devices for use by people with diabetes that make it much easier to track blood glucose. These fall into two general types, a continuous glucose monitor (CGM ) and a flash glucose monitor (FGM). You can easily get a prescription for either of these devices if you meet the requirements, but that’s where the adventure begins if you expect to use your medical insurance coverage.
I have been buying medical supplies from CVS for some years now, and my insurance has covered everything without problems as CVS is considered an in-network provider for drugs and whatever. So, I take my prescription for an FGM to CVS, and they tell me that my insurance will not cover it. This is curious, as my insurance says it covers this device, but I persevere and go back to the insurance company, United Healthcare, which has been providing good coverage to us for many years and ask for in-network providers for this new and amazing piece of medical technology.
The ever so helpful customer support person at United Healthcare suggests a local medical supply house that is an in-network provider for this product. I looked the company up on Yelp, and they have an extremely high approval rating, so I feel my problems are almost over. I send them the information they need, and I get a call a few days later that I need to call a person named Susan at another number. I call Susan and go through the same rigamarole I did twice before, and I send her the prescription. As I am ready to end the call I realize that I have been transferred to another company that only does mail order. In other words, the local in-network medical supplier is NOT an in-network supplier and passed me off to someone else entirely!
I check Yelp about this company, which I will not name publicly, and the reviews are uniformly terrible! I call the insurance company again, and I get the very helpful customer support person I talked to earlier and told him what had happened. He apologized profusely and gave me three more names of in-network providers of this equipment.
I failed to learn from my earlier experience and called the first name on his list. I talked to a knowledgeable person, and everything seemed fine until she said this equipment was not covered by my United Healthcare insurance! I had been referred to this company by United Healthcare! I was beginning to feel I was lost in an episode of MASH. Nothing was making sense!
I looked up the rest of the three in-network providers of medical equipment on Yelp, and they all had one-star reviews, and the comments were quite specific, so I was not going to contact any of them. I decided to give the Insurance company one more try and spoke to a cheerful and informative woman who promised to send me another and more complete list of in-network providers. This time I received a list of 15 suppliers for the FGM and the list was provided by the manufacturer of the FGM product. YAY! What could go wrong? I was becoming encouraged because I was finally closing in on the elusive FGM supplier and I could look forward to a future free of bloody fingers and cumbersome record keeping.
With high hopes, I took the list of 15 trusted suppliers and looked for their Yelp reviews. After several hundred one-star reviews complete with colorful language and curses, I finally found one company with no yelp reviews and they have been in business for many years. I will take this as a sign that they might be the supplier I am looking for and will approach them next week when they are open.
I pity the marketing VP for this FGM product at Abbott if his distribution chain gets so much bad press for their ineptitude and careless handling of customers. One of the typical comments from frustrated customers was that one particular supplier had exhibited creative disfunctionality to an extreme extent. Almost all of the negative comments mentioned that the customer service was operated by people who did not care about customers.
If there is a bright spot at the end of this unfortunate tale, I will post a comment for anyone who seeks a similar solution. I have got to believe that a product of this value can be delivered as promised with the help of some enlightened management.