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Head in sand over Blue Cross changes

Discussion in 'Parents of Children with Type 1' started by momof3sons, Nov 20, 2013.

  1. momof3sons

    momof3sons Approved members

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    I kept thinking that the removal of NovoLog from the approved list wouldn't effect us. Boy, was I wrong! Customer service said even with a letter of medical necessity, NovoLog would not be covered. Why is this happening?

    My sons pumps with an Animas Ping. How will the transition from NovoLog and Humalog be? Will it be smooth and seamless with the same pump settings?
     
  2. HBMom

    HBMom Approved members

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    We transitioned from Novalog to Humalog with no problems at all - hope it is the same for you!
     
  3. RomeoEcho

    RomeoEcho Approved members

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    I have used Novolog, humalog and apidra interchangeably. There may be subtle variations, but no more so than the variations I have day to day or week to week anyway. I wouldn't worry about it.
     
  4. AmyJoeBut

    AmyJoeBut Approved members

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    I had no idea about the change. I'm going to call our provider today! Thanks for the heads up!
     
  5. ecs1516

    ecs1516 Approved members

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    I called and they told me it depends on our insurance. That not all Express Scripts users will get letter. We have not.
     
  6. meganmac

    meganmac Approved members

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    I found out by happen stance that the same thing is happening with Cigna. No letter yet, just found out exploring the website. I called customer service to confirm my finding. Novolog will become Tier 4, which means you pay 50% of retail?per vial! I have no problem switching to Humalog, I do have a problem with not being notified yet of the change.
     
  7. mmgirls

    mmgirls Approved members

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    OUR Cigna Apidra will be excluded from coverage, wil have to pay full retail. Good thing I have a stockpile until I figure it out.
     
  8. sincity2003

    sincity2003 Approved members

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    So I'm wondering if we have NOT received a letter from Express Scripts, does that mean it won't affect us? Or are they just not going to tell us until we try to re-order? I'm doing a 90 day supply on 12/15, so I won't have to re-order until March, but it would be nice to know...
     
  9. 3kidlets

    3kidlets Approved members

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    I just got the express scripts letter on Monday. We use Apidra. The cde wrote a prescription so for now we have a stockpile. Not sure what we will do come January.
     
  10. Joretta

    Joretta Approved members

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    If you have private insurance go to the website and get the discount programs.

    By the way not buying insulin and showing you have a stock pile shows your insurance less need. This could be a way to see who still buys and who does not.

    I don't get how they can refuse letter of medical necessity, my child is allergic to Novalog and runs twice as high on humalog we have documentation, so how can they just do this.
     
  11. sincity2003

    sincity2003 Approved members

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    Well, I'm still buying a 90 day supply...I've just timed it so that it refills the end of December and I wouldn't be due to renew until end of March anyway. No stockpiling of insulin here :)
     
  12. BrendaK

    BrendaK Neonatal Diabetes Registry

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    We have not received a letter, but when I've called (a couple of times), the answer is the same. If you have Express Scripts for pharmacy, they will not cover Novolog for anyone, period. I have also called Novartis and they're answer is also the same.

    However, it's interesting on my online pharmacy account with express scripts, there is an option for me to auto refill my Novolog on 1/15/14. I called because I was irritated that I could auto refill this Rx with no notification that I would be charged $900.

    Time will tell. I just did a 90 day supply for both me and Carson and the endo is ready to prescribe Humalog if needed.
     
  13. sincity2003

    sincity2003 Approved members

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    we got the letter today. They will not cover Novolog, we must go to Humalog. Also, got a second letter, they will not cover Freestyle strips, we must move to another brand, that I can't even remember.
    Not unexpected, but still frustrating to say the least.
     
  14. Melissata

    Melissata Approved members

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    We haven't gotten a letter, but I can't believe that they can get away with not allowing Freestyle strips to go with the Omnipod PDM. I will certainly fight that. She does much better on Novalog than H also. Why do they have to make things more difficult for us? Hoping that Medicaid will just pick these things up for her then, unless they are making changes too.
     
  15. MomofSweetOne

    MomofSweetOne Approved members

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    The letter we got from Express Scripts said that Medicaid still had more options.
     

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