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Old 07-04-2012, 06:57 AM   #1
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Ketone Blood Testing

As we've discussed before, the strips for blood testing ketones are very expensive. Next week Im having my annual appt with my Dr who recommended low carb to me. Im wondering if its possible for her to prescribe the test strips in a way for my insurance to partly cover them? I messaged Jimmy Moore, and he said he didn't think so....but I thought I would post it here too in case anyone knew the ins and outs of insurance.
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Old 07-04-2012, 07:26 AM   #2
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This is just my opinion, but I wouldn't bother with those 'test strips' at all.

When I first did Atkins way back in 1973, I was always discouraged by the fact that my strips were only light pink and many days failed to change color at all. Yet I was consistently eating <20g of carbs and losing weight well.

I've since learned that all sorts of bodily issues (especially level of hydration) can influence the color of the strips, making them essentially meaningless.

If you're eating on plan and watching your carbs, I don't know why you would bother with the strips--especially since they cost money.

If you check my stats, you'll see that my loss was entirely from eating low carb without once 'testing' for ketosis. I've been maintaining for almost a year, eating low carb and not worrying at all about 'testing' for ketosis.
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Old 07-04-2012, 07:42 AM   #3
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I wouldn't know about insurance covering them and would suspect that you would have to be a diagnosed diabetic at very least....

I would love to hear what your findings are if you are able to start testing. Such an interesting subject!!
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Old 07-04-2012, 07:47 AM   #4
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I found my test strips at Meijer, I think, about 2 years ago when I first tried Atkins, and they were only like $8 for a 50-count. Not sure if you could still find them there for that price, or at all, but I think that's pretty reasonable, and probably less costly than a prescription would end up being.
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Old 07-04-2012, 07:50 AM   #5
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The o.p. is talking about blood ketone stips - not urine testing. I believe they run about $6 per strip.
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Old 07-04-2012, 08:09 AM   #6
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I completely agree with Leo. Unless you have money to burn, there's no utility in ketone testing.
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Old 07-04-2012, 08:11 AM   #7
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...I think he would prescribe them if you were diabetic, Carli.
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Old 07-04-2012, 08:13 AM   #8
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Im more of a numbers girl...and am mostly just curious. I was able to snatch up some test strips on ebay for a reasonable price (less than $2 each). They will be here within a week or so..and I'll give it a whirl.
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Old 07-04-2012, 08:33 AM   #9
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Quote:
Originally Posted by Carli View Post
Im more of a numbers girl...and am mostly just curious. I was able to snatch up some test strips on ebay for a reasonable price (less than $2 each). They will be here within a week or so..and I'll give it a whirl.
Yaa!! Let us know!!
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Old 07-04-2012, 08:49 AM   #10
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Asking the doctor to prescribe them can't hurt anything. I also think you would have to be diabetic for the insurance to cover them, but who knows! In all probability the blood ketone strips are more accurate than the urine ketone strips. I say this because the urine test strips diabetics used years ago were far from accurate and only showed a general range. The blood glucose test strips we use today still have a error range of 15%, but are way more accurate than the old urine test strips.

Let us know how you do with this
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Old 07-04-2012, 08:50 AM   #11
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Quote:
I completely agree with Leo. Unless you have money to burn, there's no utility in ketone testing.
Again, the OP is NOT. Talking about urine testing which is of limited value. She is talking about blood testing which is much more accurat and is useful.
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Old 07-04-2012, 08:52 AM   #12
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What are your numbers? He might be able to come up with an ICD-9 code that would get them approved without lying... I used to do billing, years ago, and it's often just in how you code it.

Years ago, I remember processing a claim for a prenatal visit with the ICD-9 code for depression. The patient had "pregnancy-related only" Medi-Cal, so I knew depression wouldn't fly. I called the clinic. "Well, it WAS depression! She tried to kill herself -- she was treated for attempted suicide!" So I promptly coded it for threatened miscarriage. (On the grounds that if the mom died, the pregnancy would end prematurely.) It went through.

It's entirely possible that your doctor -- and, more to the point, his billing staff -- can pull something similar, given your specific medical condition. The billing department will likely know more than the doc will... They're the ones who deal with the ins and outs of the various insurance companies on a daily basis. Odds are, if you contact them, they'll be more than happy to help figure out how to make it work.
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Old 07-04-2012, 08:58 AM   #13
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Quote:
Originally Posted by Janknitz View Post
Again, the OP is NOT talking about urine testing which is of limited value. She is talking about blood testing which is much more accurat and is useful.
I know, Janknitz. I was referring to the limited utility of BOTH blood and urine testing. As Carli points out, she's a quantitative person who probably finds reinforcement in number crunching. That's OK. Many of us enjoy visual cues in life. However, the fact remains that you do NOT need to do regular ketone testing to be successful with a LC WOE..........

Good Luck,
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Old 07-04-2012, 09:02 AM   #14
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Thanks Janknitz for stressing that this is the BLOOD test for me. I've noticed that sometimes people get all up in arms over testing. If you don't want to test..don't. For me, Id like to see how my diet effects the numbers. I often hear people talk about not losing if they eat too FEW carbs...others need to eat nearly zero carb For me Im just curious how my body reacts to my diet.

I'm definitely not diabetic, but...I do have high insulin and a tentative diagnosis of PCOS (although upon ultrasound, my ovaries didn't look too bad, so a mild case) This is why my Dr recommended low carb. Weight loss aside, low carb should lower my insulin levels.

I'll ask her about it, I have very little experience with how health insurance works. Im not sure if mine would pay for the strips..discount them, etc. Im not even sure how I would go about filling a prescription for strips?? In Jimmy Moore's experience, most people haven't even heard of blood testing for ketones rather than glucose.
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Old 07-04-2012, 09:06 AM   #15
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What I found interesting in Jimmy's blog about his blood ketone testing was he found the
"magic percentage" for himself and lost 20 pounds so far..So, this is a very accurate way of testing ketones in the blood..

When he just thought he was in ketosis, he really wasn't until he tweaked his plan..Higher fat/lower protein.
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Old 07-04-2012, 09:09 AM   #16
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Yes, it is so interesting! I guess the idea that 'you either are or not' doesn't really tell the truth. I would love to learn more about this. I think it could explain quite a few complaints.
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Old 07-04-2012, 12:57 PM   #17
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Carli,

You prescription insurance should work with any brick-and-mortar pharmacies. In addition, there will probably be a "mail order" option that you may choose to use for any recurring drug to get a 3 months supply at once, instead of only 30 days (for the same co-pay as the 30 day supply from the brick-and-mortar). You may also be REQUIRED to use the mail-order option for certain items like injectable medications... and possibly this. For THOSE items, the co-pay is sometimes different. I had to take a very expensive ($100+/dose) injectable medication (Lovenox) during my pregnancy. My monthly co-pay was $150 month. I used over $17k of this drug, in the course of my pregnancy, so it WAS worth it, to use the insurance!

The people in your MD's billing office will be able to help more, but they may be able to get the prescription approved with the current diagnosis. They can ALSO contact the insurance directly, to see if it will be approved. (They should be glad to do this for you.)

If you don't need to use the mail-order option to get the strips, then your local pharmacy will be able to provide them. You walk in, and hand them your prescription. They don't have any in the store, ANYWHERE. So, they politely tell you they'll have to order it, it will be here in X days, and they'll give you a call when it's ready, ma'am. Easy as that. I promise!
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Old 07-04-2012, 11:49 PM   #18
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Quote:
I'm definitely not diabetic, but...I do have high insulin and a tentative diagnosis of PCOS (although upon ultrasound, my ovaries didn't look too bad, so a mild case)
PCOS is a syncdrome so not everyone has all the symptoms. The appearance (or lack of) ovarian cysts is NOT diagnostic for PCOS--50% of women with PCOS don't have cystic appearing ovaries. Diagnosis should be based on symptoms and blood work. I've known too many women who were told they don't have PCOS because the ovaries appear normal, only to later learn that they've had it all along
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Old 07-06-2012, 10:37 AM   #19
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not sure how much the prescription would help cost wise. my plan Cigna does not cover it, no matter what the doctor says. the cash price for ten Precision Xtra ketone strips is $43, for 30 is $125. so somewhat cheaper than some places but not like they are free!

I see another brand too, Nova Max Plus, which is cheaper. the best I see for this is american diabetes wholesale site. $13 for meter alone, $31 for a meter with two sample ketone test strips, $40 for a meter with ten sample ketone test strips, and $24 for a box of 10 ketone test strips alone. 3.95 shipping. Cigna's system doesn't acknowledge the existence of this brand, I think it is pretty new. ok, the novacares website has this meter free, but I don't know if that includes any strips. do be careful because the strips people usually talk about for these machines are the glucose strips. you need to be specific KETONE strips. and NOT urine test strips! *sigh*

I know Jimmy Moore said something about being able to get a meter and some strips free, but I think that was the Precision Xtra brand where the ongoing cost of strips is higher
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Old 07-06-2012, 10:57 AM   #20
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I would skip the strips. They really are not important. Eat clean, lose fat, lose inches. Repeat.
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Old 07-06-2012, 12:03 PM   #21
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I would skip the strips. They really are not important. Eat clean, lose fat, lose inches. Repeat.
this is the standard wisdom, yes. but for many very difficult metabolisms, tinkering with carb intake is needed to get into ketosis. some need to get way below 20 grams of carbs a day and have to severely limit protein too. remember atkins and the fat fast? this is for people like that. and then, if you get into ketosis with a fat fast, how many carbs can you go up to? it varies and this monitor will tell you.
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Old 07-22-2012, 03:22 PM   #22
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My local pharmacy had to order them in for me, at $19.99 per box of 10. Seems to be the going rate up here.

Not many days I buy something cheaper in Canada then it would cost in the US! (except maybe health care) Let me circle my calendar.
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