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NIGHTSTAR-71's Photo NIGHTSTAR-71 Posts: 159
5/24/18 8:26 A

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If we did not have the problem to take medicine we needed in stead medicine what is "cost effective", very stupid sound, if it is effective, then why pay more, but if it is not effective, then why do I need it even it is not costly?
Recently I got into problem Dose of Insulin I need dramatically increased. Not it is 600 units daily. So, mail pharmacy did not want to sent it to me. I need the dose I need, not higher, nether less. So difficult to get.
Finally I got supply. Very expensive.

FANCYQTR's Photo FANCYQTR Posts: 14,774
4/15/18 5:10 P

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I can remember people saying that a prescription wasn't necessary for insulin before. I didn't even realize that. I thought it was just testing supplies and now the pharmacies are requiring subscriptions for those, here. Insurance only pays if something is by prescription.

I mentioned the problem on FB and found out that the Albuterol is a lot less than what I was told. Maybe I was told for a higher dosage? I wouldn't think so since it is mainly to prevent this from turning into asthma, I think. My 3rd cousin has asthma and the Albuterol is less than $15 for him and I was told $64.

Anyway I wondered how many people have problems with getting anything life-saving covered. To not cover something like insulin seems pretty bad to me. A friend is on oxygen and it took a few months for the approval to cover her oxygen when she needed a refill.



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NIGHTSTAR-71's Photo NIGHTSTAR-71 Posts: 159
4/15/18 10:44 A

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I think it is different plans in Aetna,
My plan covers everything. I take Insulin big dose, now it is 600 units. Before that it was 300 units dai;ly dose. Aetna covered all.
I cannot take generic so I take Lipitor only, 80 mg daily. It is all covered but I pay, $30 for three month delivery.
Aetna paid for my scooter, bi-pop, home care if I will take it, nurse almost every day.
So, I think, even company is the same they covers us differently. I do not know why.

MSANN59's Photo MSANN59 SparkPoints: (151,714)
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4/15/18 10:01 A

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welcome me and hubby had Atena they wouldnt cover our insulin so we went to united health care just pay 47 dollars each month these insurance are a headache good luck emoticon emoticon emoticon

add weight loss ticker msann59 aerobic pals


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NIGHTSTAR-71's Photo NIGHTSTAR-71 Posts: 159
4/15/18 2:10 A

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Most time I did have problem to get insulin because doc. does not Rx it. I am type 2 diabetic. Also it was when I had no one insurance.
I live in NYC. I come to hospital and I said, I need insulin but I do not have med. cover. I paid $15 and I got what I needed.
Now I do have Aetna. It covers all insulin I need, about $2000 monthly.
I do take Albuterol. It is for Asthma. It is not expensive. Why it is not covered? Looks like you do not have another med for Asthma such as Symbicort, very effective, or Simbolta. It is Brand med, very expensive. It is about $ $200 - 300 for one inhaler. I have to pay co-pay for this med. The med for Asthma usually only Brand. Albuterol is not.
To get what med is covered and which one is not. Best way to call to customer service, and they will say to you. At least they have to.

FANCYQTR's Photo FANCYQTR Posts: 14,774
4/15/18 12:19 A

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I don't run into this for my diabetes, but for allergies. I am wondering, though, if those who need insulin have trouble getting coverage for it. The pharmacist told me that many insurances are denying coverage for life saving things and I know that in the last couple of years The changes in coverages I have received show that most insulins have been dropped from the formulary.

In my case, and what reminded me of this, was an order for Albuterol and it was not approved for coverage. I wonder if they have dropped coverage for the Epi-pen that so many with allergies need and the pharmaceutical company raised the price of so high. What else are they all refusing to help people with?



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