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Unfucking Believable. . .

So while I was in Phoenix, I ran out of my long term lantus insulin the one bottle I had, was supposed to be a 30 day supply. I picked it up on 1/4, when the Insurance company said I could have my refill.

I called my pharmacist today, and *attempted* to get more, I'm being told that my insurance company will not pay for the insulin, and that based on the way the prescription was written, It should have lasted me until the 28th.

We went round and round in this circular discussion, and I was told that I could buy it outright if I wanted to. I declined, because $80.00 for 10ML of insulin is fucking piracy.

I'm going to call the insurance company, and bitch a fucking fit.

Then I'm going to call my Dr, and have her write a prescription to have me instructed to take double the amount of insulin I should be taking so this never happens again.

Rev

Comments

( 11 comments — Leave a comment )
unwittingly
Jan. 23rd, 2007 03:05 am (UTC)
Unsolicited advice from an evil corporate drone
Being that I work for a major prescription benefit company, I can tell you that they will often call to verify the instructions with your doctor if the prescribed amount exceeds the manufacturer's recommended dose.

Then again, maybe your doctor is one of those people who writes "Lantus, 30 day supply" on the RX instead of specific dosage info. The insurance company/retail pharmacy can have a field day in interpreting that to their advantage.

Also, some plans will add a limit to the amount of medication they will cover regardless of your therapy unless you put through a coverage appeal or prior authorization. This isn't done very often with insulin, though.
razorslave
Jan. 23rd, 2007 03:40 am (UTC)
Re: Unsolicited advice from an evil corporate drone
**nods**

No my Dr Writes out the Perscription, the bennefits company divides the daily dose (36 units currently) into the 10ml bottle (1000 units) and it comes up to 27.77 days (which at least when it was that close with the Novologue, got me an extra bottle. .) two days shy of a 30 day supply. . .


They say the maximum they can authorize another bottle is the 24th, 1 week before it's supposed to be used up.

looking at my Lantus Use over the last month, as I track every test and every injection. . .

From 1/4 - 1/15 I used 498 Units of Regular due to elevated bloodsugar levels due to cortizone injections and being ill. . .

Rev
razorslave
Jan. 23rd, 2007 03:41 am (UTC)
Re: Unsolicited advice from an evil corporate drone
Lantus *not* Regular
slapcat
Jan. 23rd, 2007 03:32 am (UTC)
Insulin should be one of the exceptions for the 30 day refill policy most insurance polices have. It could be a matter of life and death/trip to the ER, not "Oh well, I could go another few days or weeks without it".
razorslave
Jan. 23rd, 2007 03:42 am (UTC)
you would think so, especially with the dynamic forms of treatment and the sliding scales most patients are treated with. . .

Rev
missplatypus
Jan. 23rd, 2007 03:54 am (UTC)
I had the same thing happen a few times towards the end of my pregnancy when I was upping my does every few days. So I had to fight with my insurance and have my doctors office call and fight with them some more. If they weren't going to cover the pregnancy it self I was going to harrass them into covering my fucking insulin. When they were getting 15-20 calls from me a day they kinda got sick of me. teehee. I don't have the time for that now other wise they would have gotten a huge shit storm when they tried to tell us Audrey wasn't covered at all after she was admitted to ICU. They just love to butt-rape the public.
razorslave
Jan. 23rd, 2007 05:06 am (UTC)
yeah, I may make my way up the food chain at the insurance company. Have to decide if it's worth the effort or the time. . .

Rev
washu73
Jan. 23rd, 2007 04:15 am (UTC)
What were you living on if you were out? You can't just go without your insulin. O.O
razorslave
Jan. 23rd, 2007 05:05 am (UTC)
it was the extreme long acting (23 Hour) version of the insulin. It gives me my baseline all day long, and Then I inject Novologue (15 min - 4-6 hrs) with Meals and it keeps me fairly close to where I need to be, I think it's going to go up again, but I want to see what the affect of the regular exercise is before I adjust it more.

Rev
missplatypus
Jan. 23rd, 2007 07:45 am (UTC)
My dose has lowwered so much since my last script was written If you need a shot or two let me know
razorslave
Jan. 23rd, 2007 09:12 pm (UTC)
thanks, I appreciate it, but I'll be ok, I just have to take Novologue a lot more often until tomorrow when I can pick the new bottle up.

Rev
( 11 comments — Leave a comment )