Monday, December 16, 2013

Coverage Changes for Prescriptions

I recently got notification from my pharmacy benefit that they will no longer be covering my Novolog insulin. I am really surprised by this considering that Novolog is cheaper than Humalog Insulin. I know my copy is the same but I was really surprised by all the changes I was notified about. They will now only cover One Touch test strips and not cover at all the other brands of test strips as well. They even cut a larger amount of the type 2 Diabetes drugs they cover down to only a few. I know for me when I had pump site issues part of the issue for me was I had been on Humalog for way too long and it was not as affective. So I am really worried about what I am going to do when the Insulin I am doing well on is no longer covered. I find all these changes in my coverages frustrating because they really leave me without choices in the Diabetic products I am able to use.

Thankfully my One Touch Ping does use One Touch test strips and so will the Verio IQ which is covered thankfully. If I was using Medtronic the Bayer test strips would not be covered or the Ominipod the freestyle test strips would not be covered either. So that really limits what options the patients have. I am not sure why the dramatic cuts but the most interesting part of the changes the insurance only covers the most expensive brands. The copay is the same currently regardless of the brand and you would think the insurance company would want the cheaper version of the products covered. I have a feeling they have contracts with certain companies to only cover those products. I am incredibly frustrated this year first by them refusing to cover the 600 test strips a month I need and the having to wait for an approval for the year to get that many test strips and the sad part is that because of my EMS history is the only reason I get the number I am requesting.

I am really hoping they don't have any more big changes because just trying to fill a prescription has become such a chore at this point. Thankfully when I reordered more test strips recently the order came through without issue. I am not a fan of the lets limit the testing as much as possible plan because that increases the odds of complications. I already have some and I am trying to keep things as controlled as possible but with the insurance company not covering much of anything my goal to keep myself healthy will become increasingly difficult.

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