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Lantus not approved by Blue Cross

Discussion in 'Insurance Issues' started by Gianna's Dad, Jan 21, 2010.

  1. Gianna's Dad

    Gianna's Dad Approved members

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    We just changed insurance companies and under Blue Cross HMO I can not get lantus for my daughter. Has anyone else had issue with this before? Thanks!
     
  2. Amy C.

    Amy C. Approved members

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    That is quite odd. Lantus has been on the market since 2001 and used by many Type 1 children.

    Which insulin do they approve?
     
  3. PAULEEN

    PAULEEN Approved members

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    confirm with them that they are not billing the inpatient part of blue cross. A lot of the Blue Cross (especially HMO) have a diffrent name (ie: United Health Care) for the regular medical expenses...we've run into this occasionally. Good Luck.
     
  4. Gianna's Dad

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    I believe my pharmacist said that Blue Cross will only pay for Levemir and that if we insisted in getting Lantus, we needed to have the doctor call Blue Cross and apply to have Lantus authorized. I spoke to my daughter's endo and she stated that they are aware of the problem with Blue Cross and Lantus. I really dont know how all of this is going to end but I really dont want my daughter to switch from using something that has been working for the last 6 years.
     
  5. BrokenPancreas

    BrokenPancreas Banned

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    I wonder with the whole Breast Cancer/Lantus POSSIBLE connection that was all over the news months back might be the reason that they aren't covering it?
     
  6. Toni

    Toni Banned

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    Have the endo override the insurance company, prescribe Lantus. You will have to get an Authorization code. Done all the time. Levimir may or may not work as well as Lantus for your child. Lantus is more expensive than Levimir and I believe that is the reason.....
     
  7. TheFormerLantusFiend

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    I use Blue Cross Blue Shield of Illinois and Lantus is on the formulary.
     
  8. Thoover

    Thoover Approved members

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    We have BCBS and they do approve Lantus. I also work for many different insurance companies including BCBS CareFirst and I know for a fact that Lantus is on their formulary. I would contact Blue Cross and speak with someone, you may have a long hold time on the phone but it will be worth it.
    Please let me know if I can help you out. I do this for a living.. :)
     
  9. chbarnes

    chbarnes Approved members

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    I agree. This is all about cost. They will probably approve it if your doctor says it's necessary.

    Chuck
     
  10. Flutterby

    Flutterby Approved members

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    Lantus is approved for ages 4 and up, thats probably why.. I would have you endo fight it.. she'll need to contact the insurance company. Never mind, I thought your daughter was 13months old.. I read your signature wrong.:eek:

    That said, we have BCBS and never had a problem getting lantus for Kaylee, who was 2 at dx.. seems odd that they wouldn't cover it... my guess, its more expensive? I believe levermir acts the same way.
     
  11. TheFormerLantusFiend

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    Levemir is twice as expensive, at least if you pay OOP.
     
  12. MsDrina

    MsDrina New Member

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    Insurance shock

    I am so sorry to hear that. We have been considering Lantus for my son, because he has been so unstable with his blood sugar levels. We have Blue Cross and Blue Shield as well. We may have to seek an alternative; the prescriptions and supplies can get costly. Thanks for the information.
     
  13. Amy C.

    Amy C. Approved members

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    Not all Blue Cross Blue Shield companies are the same. We can get Lantus without any problems.
     

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