does anyone have any ideas on how to get ones new insurance to cover a current medication that is working?

bfoley8417
By bfoley8417 Latest Reply 2011-09-07 18:34:47 -0500
Started 2011-07-23 20:43:16 -0500

i have recently changed insurance and new insurance refuses to continue several different medications i am on one of which happens to be my insulin pen. any suggestions on how to fight it? would be greatly appreciated. i am very frustrated!!!! thank you


8 replies

Caliafiosgram62
Caliafiosgram62 2011-09-07 18:34:47 -0500 Report

Most insurance companies have an appeal process. I went through that when my new insurance refused to let me have my CGM sensors. I got my endo involved and when we convinced them that if I went into the 40s I could be in trouble they relented.

edvel54
edvel54 2011-07-25 22:56:09 -0500 Report

my insurance will not cover insulin pens, they said that bottles & syringes were cheaper.
Is the insurance through were you work? Ask other workers if they have the same problem, contact your boss and talk insurance with them..He may be able to help.

JoleneAL
JoleneAL 2011-07-24 07:00:02 -0500 Report

Did they say "why" they won't cover it? Are they wanting you to use a different brand or generic?

bfoley8417
bfoley8417 2011-07-24 08:58:34 -0500 Report

no they will not talk to me i was told the doc needs to call them and deal w it so i did that last wk and am waiting for a call from my doc if i do not hear from them by tues i will cal doc back but this is very frustrating.

bfoley8417
bfoley8417 2011-07-24 00:27:38 -0500 Report

have tried that they wont we r continuing to work on it but iwill not change can not due to other issues. so i have made that clear will stop taking altogether if the insurance changes it. it may be wrong to quick but am ired of making all these changes and feeling sicker. thank you anyways.

jayabee52
jayabee52 2011-07-23 23:26:28 -0500 Report

The only way I could think of to suggest to do that s to get with your Dr and have him/her write a letter to the ins. co. explaining the medical necessity of you taking those particular medications. And have Dr emphasize the cost savings for that plan of treatment. As long as there are not easily usable alternatives the ins. co. may give permission to use that plan of care/those meds.

However, the ins. co. may consider an insulin pen a convenience to you and want you to use insulin vials and syringes to administer your insulin(s). If that's the case, you have to determine how hard you want to fight this battle with them. The added stress on you may not be worth higher BG numbers.

I pray that you can get the ins. co. to approve your Dr's plan of care as is.

James

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