20 Comments
In the past year, has your health insurance required you to change medications or devices?
You must be logged in to post a comment.
© 2022 T1D Exchange. All Rights Reserved.
This year I had to switch to using One Touch meter/strips because that’s the only brand my insurance covers at the normal co-pay. Any other brand would cost me a lot more money.
They didn’t cover my Endoscopy preferred insulin on diagnosis, but suitable sub is working fine. I’m not sure how docs determine which insulin is appropriate anyway, think it’s what they’re used to.
In order to have my insulin covered under Medicare Part B with Advanced Diabetes Supply, I had to switch from Fiasp to Lispro .
Not changed but costs more due to the fact the meds I need are not on their formulary or are tier 3 or 4. The so called donut hole does not look like it’s going to be dealt with by insurance companies
Wanted me to change test strips (meter works with my closed loop system). Doctor wrote a pre authorization so that I could keep using the test strips he prescribed.
None of the diabetes medications are covered under insurance in India
I was using Medtronic’s 670g pump and guardian 3 sensors. When I switched to Medicare I had to re- prove that I was a T1D to get Deccom because they don’t cover guardian sensors. It took three months to get everything sorted out.
My health insurance supplier has required a change in medication but only to a generic brand. This has saved me a lot of money.
Despite all of the negatives with Medicare “rules” relating to diabetes pump and CGM supplies, doctor visits, etc., I have not had any issues with changes to medications and devices.
They want me to change to Humalog, even though I’m allergic to it. So I’m forced to pay for Novolog (while I wait to see if I qualify for assistance from the company and ration what I can afford to buy). There are currently no Medicare plan’s in my area that cover it.
I had to change from Humalog to Novolog because Aetna removed Humalog from their formulary list. I haven’t noticed a difference.
I had to change my glucometer since the insurance didn’t cover the strips for the Freestyle Lite. I really liked that one since it had a light in it, which allowed me not to turn on a light at night. The new is doesn’t consistently work or doesn’t always like the test strip. I’ve had to use multiple strips to get a good read.
“Other” was my response. My insurance didn’t require me to switch insulins, they only subtly switched their preferred formulary brand without telling me and my co-pay more than doubled. My Endo discovered this and switched me over to the other brand. Saved me $60 per refill (went from $100 to $40).
But they also don’t cover the devices and supplies I do use.
My insurance changed less than a year ago and every time my insurance changes, so does which Insulin the insurance will allow me to get. I’ve lost track of how many times I’ve been switched back and forth between Humalog and Novolog Insulin by my insurance over the past decade.
Started medicare this past January. I was using Afrezza and Tresiba. I could find only one supplemental or advatage plan that would cover Afrezza at the highest tier. I decided to get the tslim pump instead to not have to deal with such high prices! I have had dufficulty with pump use before Afrezza due to absorption problems after 59 years of TD1. So I was not forced to change but did not want to change
No. The only thing they do not cover is Baqsimi, (which is my preferred choice) but they do cover the Gvoke hypo pen – which works for me as second best choice. I am hoping that the powers that make tier coverage decisions will get onboard and approve Baqsimi in the 2022 formulary.
This is frustrating. Truly. Insulin is not insulin. One long acting basal vs another yields a totally different experience and outcomes/individual impact should be the measure, not agreed upon price points set to maximize profit.
Yes, had to switch from Novolog to Homolog and my test kit, from a One Touch Verio to a Contour … both work well so no issues.
Not in the past year….. but prior to that yes. Insurance companies should NEVER have the power to require a change in medication or devices. THIS GOES FOR THE FDA IN THEIR ‘guidance’ on number of test strips for Type 2 (1 strip / day) and T1D (3 strips/day). Insurance companies claim their quantity limits are “for your safety” …. “we are following the FDA requirenments…… FDA should not set a specific number… it should say “a minimum of 3 strips/day”. Insurance companies and especially 90-day pharmacies (PBMS) take these ‘recommendations’ and make them ‘hard and fast’ “all diabetics should only use 1 strip/day. Sorry about the rant.