Have you ever been in a situation where you used up your 90 day supply of insulin well before the 90 days are up? It happens to me quite frequently. In fact, it happens, every single time. I’m usually always down to my last insulin pen or vial when I am re-ordering and it’s a day or two before I am allowed to re-order according to the insurance company.
Why does this happen a lot?
Well, it’s simply because I don’t know 60 days from now what’s going to cause me to use more insulin. I have a goal and a prescription for how much insulin I am to use per day, but guess what? Life happens!
Sometimes I eat more food.
Sometimes I run high all day and need more corrections.
Sometimes insulin goes bad for whatever reason.
Sometimes because of owning a business and having a 3.5 year old, I get stressed out and it requires more insulin.
Or, as in this last case, I was sick for about 2-3 weeks which kept my BGs more elevated than normal, so it required more insulin to keep them in check.
All of those reasons ended up forcing me to use up all of my insulin before the 90 days. In fact, it was day 65 when I was totally out.
Insurance companies usually become flexible around that 75 day. At 80 days, I’ve never had a problem refilling a prescription, but 65 was going to be tough.
Major Insurance Battle
I thought that I was going to be up for a major fight with the insurance companies over needing to override this and that to help me get my insulin. Last year, I attempted to re-order around the 60 day mark and they wouldn’t pay for anything, so I had to pay $150 for 1 vial of insulin because my local Walmart was out of Novolin R until the next day.
When I called CVS to have them refill my RX, they told me that I had no more refills on file. This was after 5 PM on Friday when my doctor’s office was already closed. So, now I knew I had to wait until Monday to at least call this thing in.
That meant I had about 20 units of insulin left in my pen until Monday at the earliest. Obviously that wasn’t going to work.
Rationing and Borrowing Insulin
Unfortunately, and fortunately in this case, I have a family member who is also Type 1, and I was able to borrow insulin from them. If not, then I had already called the local Walmart to see if they had Novolin R in stock, which they did.
So, I had to ration out the 20 units I had Friday night, which meant that I ate a very low carb meal and skipped out on dessert. For my Tresiba shot that night, I almost doubled my basal insulin because I’d rather that help keep my blood sugar low over the 24-48 hours since I had plenty of Tresiba.
Monday morning came and the very first thing I did was call the endo. I’m not a big fan of the way my new endo office is set up. He is part of a large hospital system, so the phones are answered by a central answering service who takes all your information and then relays it to the doctor’s office. That makes me feel like a Patient ID number and I don’t like that. I like to be able to speak with the office staff and nurses directly and build a rapport with them.
I guess I was just spoiled with my previous office in Florida. When they saw my name on the caller ID they were happy and excited and joked with me and sometimes would answer the phone with, “Mr. Stocker, what do you need this time?”. And at the end of the day, I knew that when I called them, they would drop what they were doing and help me get what I needed immediately.
I don’t feel that way about this endo.
But, I digress.
Texts from CVS
I received a text from CVS Monday evening that my RX was received and that they will alert me when it’s ready. Tuesday evening came by and I received the text from CVS that the RX was ready for pickup. I clicked on the link they give you to see what the estimated cost was.
I was waiting for it say like $3,500 but, it said $25.
PHEWWW!!!
That means the insurance was going to cover it!
So, when I got to the pharmacy, I asked them if they had to call in for an override or anything and they said, “no, we had to call in a new RX and it was a different amount than your previous refills, so the insurance probably just covered it because it’s an updated amount.”
AWESOME!
So, not having anymore refills and having to call in a new RX, which I always hate, actually worked to my benefit this time.
The moral(s) to this story are this. Don’t wait until you open your last pen to start thinking about refills or what you are going to do because it may require more time and a weekend which slows things down a bit.
If you are running out of insulin, or have no insulin, please either go to the ER or go to Walmart to get Novolin R, yes it’s not as effective, but it’s more effective than nothing.
I have experienced the same Chris.