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[IP] Novolog being refused by insurance
- To: email @ redacted
- Subject: [IP] Novolog being refused by insurance
- From: Kasey Sikes <email @ redacted>
- Date: Fri, 01 Feb 2002 17:15:31 -0500
- Reply-To: email @ redacted
- User-Agent: Mozilla/5.0 (Windows; U; Win 9x 4.90; en-US; rv:0.9.4) Gecko/20011128 Netscape6/6.2.1
I found out today that Kayla's insurance will no longer pay for Novolog.
VERY aggravating since, for the first time since she started pumping,
her numbers have been perfect thanks to Novolog. Has anyone else had a
problem with having an insulin prescription denied? And if so, was
there any recourse?
I went round and round with the insurance (PeachCare for Kids - a state
program one step up from Medicaid) on the phone today and had no success
with getting it covered. I explained that the only other analog insulin
alternative was Humalog, and she was allergic to it. They even called
her endo who said he absolutely would NOT approve replacing the script
with Humalog because of how bad her control was while on Humalog and how
good her control is with Novolog. I also told the insurance rep that
Novolog was the only insulin analog approved for use in the pump and
that it didn't seem right that they could deny it. He said we didn't
have to use an analog and I told him that in the pump you had 4 insulins
to choose from (R,V,H,N) and only the V and N were FDA approved for
pumps, both of which were made by the same company and so probably both
would be denied. He checked and sure enough, V is not covered either.
His solution was that we either paid for the Novolog out of pocket or
switch to Humalog or go back to shots because we could treat the
diabetes with shots - the pump wasn't the only way to treat it. OH I
GOT SO MAD!!! And Novolog is $55 a bottle.
Sorry, I had to vent. If anyone has had a similar experience and was
able to resolve the dispute, please let me know. You can e-mail me off
list if you want.
mom to Kayla, 8yo, pumping 3+ years
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