Maya Zuiderweg <$no_spam#ma_dot_zuiderweg_@_me_dot_com#maps_on$> wrote:
> Ozlover drukte met precisie uit :
> > Maya Zuiderweg <$no_spam#ma_dot_zuiderweg_@_me_dot_com#maps_on$> wrote:
> > [...]
> >> Good for you. The day before yeasterday I phoned the Diabetes
> >> Vereniging Nederland, they have all the information about (different)
> >> insurances, covering the costs of strips, of BGmeters, and a lot more.
> >> I thought I had read somewhere that there was an alteration in the
> >> coverage of strips per day, i.e. MORE coverage re costs.
> >> No way. Its even worse than before.
> >> Some years ago one had to prove (via specialist)that one used insulin,
> >> that was enough to get coverage for 4 strips per day.
> >> Right now thats not enough anymore. Specialist must fill in forms to
> >> prove that one has type 1 and/or use a pump.
> >> All these people with type whatever, but DO use insulin, dont get
> >> coverage anymore.
> >> Insurance companies make the rules here, which is a bloody shame, as
> >> they only are interested in making heaps of money for themselves.
> >> Patients? What alien species is that :-(
> >> M.
> >
> > Maya, as I said before, please don't make blanket statements about the
> > policies of Dutch insurance companies, because the *is no* single
> > policy!
>
> You tell that to the DVN, they'll laugh in your face.
Please READ and try to comprehend a posting, before making silly
statements like that. Either the DVN rep was clueless or you
misinterpreted what (s)he said. My money is on the latter.
> > Case in point: As you know, I'm a med using T2 and get free strips.
>
> Diabetes specialist's orders I assume. He/she knew how to convince your
> insurance co to be lenient. This what we call a "coulance-regeling".
Exactly *which* part of "GP" didn't you understand!?
And he did not do any "convincing". He just wrote a prescription and
the pharmacy filled it. No "coulance-regeling" involved. End of story.
> I use a minimal of 6 strips per day, I went via the ombudsman, who
> wrote a letter to my insurance co. This all because of commitment of
> the DVN.
So *your* insurance company's *actual* *practice* for *your* level of
insurance is different than mine. Duh!
> > What the Diabetes Vereniging Nederland probably meant is the *minumum*
> > benefits which *all* insurance companies *must* offer, not the *actual*
> > benefits which *each individual* insurance company *does* offer. AFAIK,
> > the actual benefits also depend on the level of insurance you have, i.e.
> > yes/no additional ("aanvullende") insurance and *which* additional
> > insurance.
>
> Basal insurance package, that we all _have_ to take and pay for: is
> what the DVN talked of.
READ and try to comprehend, will you!?
AS I SAID, the "basis verzekering" describes the level of benefits
which *all* insurance companies *must* offer, not the *actual* benefits
which *each individual* insurance company *does* offer. I.e. also for
the "basis verzekering", what company A offers and what company B
offers, can and will be different.
If you don't believe that/me, then look at the policies for meds,
which meds company A (fully/partly/not) pays for and which meds company
B (fully/partly/not) pays for, *is* different. It's called
"preferentiebeleid" (preference policy). Look it up. My wife and I have
two different insurance companies and their "preferentiebeleid" is
different and even for the same company the "preferentiebeleid" differs
from year to year, i.e. a med which is fully/partly/not payed for one
year, maybe not/partly/fully payed for next year. Been there, done that,
did (not) get the T-shirt.
> > AFAIK,
> >
> > FYI, a few days ago I was at my doctor's (GP's) office and asked for a
> > prescription for more strips, he did it right away and on his screen it
> > said "depending on contract" ("afhakelijk van kontrakt").
>
> QED.
Nope. It depends on the contract between the insurance company and the
*drug supplier* (and pharmacy), *not* (only) on the contract ("polis")
you have with the insurance company.
> > Botto line: There is no 'one size fits all' Dutch policy for (not)
> > providing strips.
>
> Yes there is: 4,4 per day for type 1 and/or pump users is the policy.
>
> _Exceptions_ *can* be made, with the help of a good diabetes
> specialist.
False: In my case: No specific number of strips, T2, no pump, no
exception, no "help", no "specialist", just one *computer* (the GP's)
talking to another (the pharmacy's).
> Or, in my case: the DVN and the ombudsman. That was in the 90's last
> century though. Right now the DVN advises to let your _specialist_ fill
> in some forms so you have a chance for more than the 4 strips per day.
Your experience is just that, your experience. My example(s) shows
that your experience is not cast-in-stone policy for all insurance
companies.
> Phoned the DVN last Wednesday.
Call them again and ask them if *some* insurance companies have *more
lenient* *actual* *practice* *without-asking* (i.e. *not*
"coulance-regeling"). If they stick to what you think/say they said,
then tell them they don't know what they're talking about and feel free
to say that I said so.
EOD.
--
Frank Slootweg