I wanted to point out that you can appeal bills/billing too. I cannot help much on that aspect, as I have no experience appealing bills, although I pay for my healthcare. I would avoid killing two birds with one stone by trying to get approval for insulin/test strips AND decent billing, as this is too risky and high stakes. Appeal for billing AFTER you get approved, even if it hits you in the pocketbook. You can always request in the billing appeal to get a reimbursement check, one way or another, for previous prescription fillings that occurred while the appeal process occurred. Just expect for that to be a huge hassle, as Express Scripts is extremely incompetent. Express Scripts needs to get screwed by competitors. There is no way that your pharmacy benefit is "competitive", or your benefits for that matter, when you only have one option for rapid-acting insulin and one choice of a major brand for test strips. Amazon is actually entering this business, supposedly.