When my doctor prescribed Afrezza, I got a call almost immediately from my pharmacy that it wasn’t covered. My doctor had anticipated this, so we continued going through the steps to get started - set up an appointment with the Afrezza rep and also an appointment for the lung function test (which was quick and simple, and I passed).
The Afrezza rep had a form to submit to Mannkind Cares, the company that helps patients get approval from insurance for Afrezza. In the meantime, they also offered a voucher for a free 30 day supply (90 cartridges).
The next thing I heard was that my insurance required me to do a 30 day trial of Novolin R to prove it didn’t work. I was on Novolog at the time, so they just wanted me to try every option in their formulary and fail before they would approve the Afrezza. I picked up my prescription for the Novolin R, and by the time my next appointment came around, just over a month had passed, and I was able to tell my doctor the Novolin had not worked for me at all (not surprisingly!). She passed that information on to my insurance.
The Afrezza rep contacted me shortly after to confirm I hadn’t received word I’d been approved; I said no. She said she was working on trying to get it approved and would let me know when it did. A week later, she contacted me again to say she had just learned the approval had gone through!
Of all of the fights I’ve had trying to get different things covered by insurance, this was by far the easiest on my side - the Afrezza rep and my doctor had to do a lot of the paperwork and pushing to get things put through; most of what I had to do was just be patient and wait out the process.
So if you are trying to get approval for Afrezza, be sure to see an Afrezza rep, make sure they are submitting a form to Mannkind Cares, and definitely take them up on the free month’s supply!