Which company do you use for home monitoring?

[DachsieMom]

I am starting the process of home monitoring. Right now I go for blood tests weekly and my veins are not happy. I have Aetna, and they recommended Alere (cardio also gave me thir brochure). I have given Alere my information and they are processing the prescription. However, I am mindful that as of Jan 1 2016 I am essentially paying 100 percent out of pocket (albeit at the insurance rate) due to my ridiculous deductible (I met it this year with surgery). I also see that people are not happy with Alere. Any other companies you would recommend? How is pricing of other companies ve Alere? I would prefer to have insurance purchase the machine, but it doesn't appear they do so. Aetna seems very unfamiliar with these machines even though they have an express policy about them. I am not comfortable buying from eBay.

 

[dick0236]

I have dealt with both Alere and Coaguchek Patient Services. Alere STINKS. I have used Coaguchek Patient Services for over one year and am very satisfied with that service. They are a division of Roche Diagnostics, the manufacturer of the CoaguchekXS meter. Their phone is 1-800-428-4674, www.TestYourINR.com. My current cost is about $25/test and my insurance(Medicare Advantage) pays 80% and I pay 20%(about $5).

 

[slipkid]

I am using Remote Cardiac Services (RCS). The device they provided me is the Alere InRatio2.

They are expensive - about $280/month without insurance, and $118 with my insurance. However work gives us $1000 worth of a healthcare spending account for meeting some health/testing/program incentives (which I did), so in reality the way it is shaking out for me with my health bills this year I will only be paying about one of their $118 bills out of my pocket, and moving forward will only be about $18 a month since I have reached my $1200 deductible about now.

Originally my cardiologist had enrolled me with Alere but in a very long story that I won't repeat (I had another thread on that last year), Alere takes my insurance but the way BC/BS bills them it doesn't work (again, long story). Took me about 6 weeks (or more) to find RCS and get this setup after that mess.

I haven't had any big problems with RCS, they send me supplies when I need them, they fax the dr's office the reports the same day, if out of range they also call the dr. I did want to go to testing every other week instead of weekly but they do not allow that (have to test weekly with RCS). I have no problem testing weekly, think it is actually the way to go, but was trying to save some $$, plus it seems like every Dr. out there that I know thinks testing monthly is all that is necessary, and thinks I am just being a pain in the ass by testing weekly.

 

[Protimenow]

A few thoughts:

Any professional who is happy with monthly testing doesn't really understand it. You can have a stroke if your INR is too low -- and this can happen in about a week or so. I know. I was using an InRatio that was giving me a result of 2.6 -- after I had a TIA, the hospital lab gave me a 1.7. It doesn't take very long to have problems if your INR is too low, and testing monthly just won't display any periods where, for one reason or another, the INR has dropped into a dangerous area. For doctors to assume that you make no changes at all during the month between tests, and that you always remember to take your warfarin is both naive and dangerous.

(My INR has been pretty stable, and I've sometimes waited more than a week to test -- shame on me. I tell whoever will listen that once a month is NOT often enough).

Personally, I don't trust the inRatio. A few years ago, I did parallel testing between InRatio, CoaguChek XS, Coag-Sense, and a hospital lab. I found the InRatio to always be high - in some cases, much higher than the labs. Plus InRatio strips have had a recall and were not available for some time.

And I don't think you're getting very good value for your money. If you are comfortable with it, you may consider getting your own meter (CoaguChek XS or Coag-Sense) and self-testing. You can always call your results in to your doctor.

InRatio meters on eBay are often very inexpensive but, again, I personally wouldn't trust one with my life. I think that the strips, when available, are probably pretty expensive, too.

Good luck.

 

[pellicle]

to the OP (and anyone else really) this point is well worth reiterating:

Any professional who is happy with monthly testing doesn't really understand it.

 

[DachsieMom]

Thanks everyone! I started the process with Alere, but based upon recommendations here and my early experience with Alere, I switched to Roche. Still in paperwork phase.

 

[Protimenow]

You'll find that, if you own your meter, the strips should run less than $10 each. (They're probably half that). The premium that you'll be paying for a 'service' to loan you a meter and make a phone call to your doctor may be something that you should consider.

I have a doctor friend who is on Medicare, and his plan requires weekly testing. I think that, under Medicare, it only costs him $5 or so each week for testing, and they gave him the meter.

For myself, not yet being on Medicare, I own my meter, and I buy my strips and lancets -- but it doesn't cost much, and I am able to get monthly blood draws to check against my meter. I pretty much ignore the clinic's 'advice' because they don't really seem to know a whole lot about management. I usually come in to the clinic (every three months) with my blood already in range. (They changed m range from 2.0-3.5 down to 2.0-3.0).

If you're confident with self-management, or comfortable with owning your own meter and buying your strips, you might save some money over the long term.

Just a thought...

 

[DachsieMom]

I totally agree about owning the meter. However, I couldn't find a company that would just sell me one (and I am not comfortable buying from EBay) - and my insurance will only do this loan arrangement. I have met my deductible this year, so plan to try it for now. We'll see once January comes, as I will be paying almost $200 per month for the service. I also intend to periodically check with my lab. If I could find a company that would sell me the machine and insurance would cover it, I would gladly order strips from Amazon or another company and pay for those myself.

 

[pellicle]

Hi

I totally agree about owning the meter. However, I couldn't find a company that would just sell me one (and I am not comfortable buying from EBay)

well for what its worth I did my Grad degree in Biochem and later did a diploma in Electrical engineering. I also have a background as an electronics technician. I have some knowledge of how all of this works. So with this background made clear let me say that I would be perfectly happy to buy one off ebay because:

1) the actual sensitive stuff is in the strips, not the machine, its less complex than a $50 phone
2) these devices are so uncommon there are no knock offs ... its not like iPhone where there are millions made and are consumer items
3) there really is very little that can go wrong with them.
4) there are plenty of people who buy them for "grannie" who then won't use it ... so sell them just to get rid of it.
5) the strips are (of course) disposable and there are no knock-offs of them

lastly my machine has been dragged around the world, bashed, taken camping and I still use it ... its still accurate because the strips are always fresh

which leads me into
6) when this machine kakks it, I'll be getting one off ebay

I test every 6 months and compare it to a lab (just to keep a baseline)

That's my evaluation.

(PS: the background on me is just so that you can determine if I have any trustworthiness / qualifications in making my assessment)

PPS: http://www.ebay.com/itm/ROCHE-COAGU...CARRYING-CASE-COAGUCHEK-LANCETS-/281741514451

seems a bargain

 

[Protimenow]

I have personally had no problems with meters I bought over eBay. One other source that Pellicle didn't mention - and it may be unique in the United States - is that clinics, hospitals, and even Government facilities consider these to be Capital equipment -- the amortize the cost of the machines over three or four years -- a completely functional machine will be retired/sold as surplus/thrown away so that a new version of the same meter can be bought with new Capital funds. I bought a meter a few weeks ago from a company that traded some new medical supplies for some old, retired meters.

The meters are made to be used A LOT, and they'll usually hold up for occasional testing that an individual will do. If you're worried about getting a bad meter, ask for a guarantee from the seller -- if it doesn't work, just send it back.

I've paid as little as $40 for a perfectly usable meter. In fact, just bought a meter for about $60 just a few weeks ago. If you're paying $200 a month to some greedy service, you can get a lot more bang for the buck if you buy your own meter and strips and test weekly. (For what you'd be paying in three or four months, you can probably buy a BRAND NEW meter)

 

[joey66]

I have used Roche Coagucheck since 2012. I have no issues with it. I get the strips on eBay for about $224 for a box of 48 strips. They are brand new strips from the manufacturer and when i had to do check ins with the doctors office to make sure my meter was reading OK, they matched up just fine. I test weekly.

 

[DachsieMom]

Thanks! Joey66, when you say you use Roche coagucheck but by strips from eBay, do you mean you just use the machine - but not the Roche reporting service? I just had my first training and home testing with roche coagucheck this week. They were great. Will stick with them this year, and re-evaluate in January when my deductible restarts. Have you ever bought lancets and strips from Amazon? How does it compare to eBay? I have a lancet holder that looks like a pen.