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Express Scripts appeal for coverage of Omnipod strips approved...

Discussion in 'Parents of Children with Type 1' started by redheadmom, Mar 14, 2014.

  1. redheadmom

    redheadmom Approved members

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    In case someone wonders if Express Scripts will cover the Freestyle strips for the pod, they did approve my appeal and I now have coverage. I only had to fill out their appeal form and told them that these were the strips that "worked" with my pump. Then they asked my doc for a letter of necessity, and it was approved very quickly.
     
  2. tannafis

    tannafis New Member

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    Oct 19, 2013
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    That's good to know. Are they covering at the normal copy or do you have to pay a higher copay for them?
     
  3. mmgirls

    mmgirls Approved members

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    So very good to hear. I was floored when I got the letter saying that they would be "excluded", not a higher tier, but excluded. Along with that was the Apidra letter.

    Since I have not heard much on the boards about it since the letters went out I assume that it was a pretty easy fix if you wanted to advocate for what you want, we have left Omni pod in the dust with this whole recall mess, well actually before it but most likely because of the reason for the recall.

    Glad it all worked out for you. We have new insurance and again have Express Scripts, I loath them, they know nothing when I call for information.
     
  4. redheadmom

    redheadmom Approved members

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    Highest copay level, but I have the copay card from Freestyle, so that will help, I hope. I'm still waiting for my pharmacy to get the "updated" strips, so I haven't gotten a bottom line price yet using my copay card.

    They did the same thing with Apidra, approving my appeal but putting it in the highest copay level. However, with my Apidra copay card, I had NO copay even still!
     
  5. moco89

    moco89 Approved members

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    That is good to hear. I am glad that you were successful with your appeal. :cwds:

    Appealing for a medication in the past was a huge hassle with Express Scripts, for me. I gave some (poorly written) instructions on doing so, on a previous thread.

    Anyone who has questions about how to appeal efficiently should reference your previous thread. http://forums.childrenwithdiabetes.com/showthread.php?75348-Apidra-approved-by-Express-Scripts-for-me
     
  6. moco89

    moco89 Approved members

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