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RE: [IP] GUIDE-LINES NOW!! PUMPERS VS. INSURANCE
I had that happen last year, Prudential had placed Humalog on the
Non-Formulary List. They would only cover Humulin insulin (duh,
isn't Humalog a recombinant dna product?) Anyway, with my
endo's letter of necessity I was told I would have an answer in 48
hrs. Good thing I had a large enough supply on hand, they finally
approved 21 days later. What was it LBJ campaigners said, vote
early and vote often. Refill your 'scripts early and often. <g>
Paul Whitaker wrote:
> A month ago I a similar experience with a Humalog re-fill. My pharmacist
> told me, "you need to get pre-approval from your insurers before I can
> supply any more Humalog". I thought my doctor's prescription was the
> approval. Following day insurers told me, "Humalog is not on our list of
> approved drugs, use a generic version instead". !!
> I was almost out of Humalog, so I left it up to the HR dept. to
sort out -
> that took 24 hrs. So now I make sure I have at least two bottles in the
> fridge for events such as this.
> I was thinking of the possible alternatives had I run out of Humalog and how
> the insurance company would have responded if I had gone to the ER to get a
> I'm going to do some serious talking with my physician,pump
> supplier.and state board of insurance. I DO NOT LIKE INSURANCE
> PLAYING DOCTOR.
Contact the Board of Insurance and your state reps. The docs and
vendors are at the mercy of the ins. cos. and Lawyers (reps.) are
the powers that rule.
Insulin Pumpers website http://www.insulin-pumpers.org/
for mail subscription assistance, contact: HELP@insulin-pumpers.org