Of all the ridiculous hoops

[Pianoplayer7008]

Can I just rant about doctors and insurance for a second? I am sick and tired of having to prove that my BG is poorly managed one way before they’ll let me try another way - is this how it always is?! In pregnancy, my MFM put me on a fixed dose of insulin, and she wasn’t willing to try an ICR until I followed her dosage guidelines and showed her how it wasn’t working (I wasn’t willing to do that and put my baby through all those highs). Now, insurance has denied coverage of Afrezza and, despite the fact that I JUST got prescribed and picked up Novolog, I apparently can’t appeal the Afrezza denial until I am on Novolin R for a month; basically have to show them a month of highs and lows to prove it doesn’t work. This is so ridiculous.

[Michel]

@Pianoplayer7008

I apparently can’t appeal the Afrezza denial until I am on Novolin R for a month;

They need you to be on Novolin R? This has got to be one of the stupidest things ever.

@Pianoplayer7008

I am sick and tired of having to prove that my BG is poorly managed one way before they’ll let me try another way

I cannot agree with you more @Eric has some interesting ideas on the subject. One thing he does, for instance, is that he never gets an A1c at the doctor, so that it does not get entered into his info (his is too good…).

@Pianoplayer7008

This is so ridiculous.

So sorry. We are all in the same boat But – the good news is that you may be able to appeal it successfully!

Make sure to gets lots of lows with Novolin R – that shouldn’t be too hard

[Pianoplayer7008]

@Michel

This has got to be one of the stupidest things ever.

Yes! And the worst part is my doc is all for it, per the voicemail from her staff I just got.

@Michel

One thing he does, for instance, is that he never gets an A1c at the doctor, so that it does not get entered into his info (his is too good…).

Hmmm, that’s a really good idea…my last one was 5, despite my control actually getting worse since the 5.3 the few weeks prior (yes, I had two drawn within a few weeks; long story).

@Michel

Make sure to gets lots of lows with Novolin R – that shouldn’t be too hard

This is what is bothering me the most. I cannot risk multiple lows while I’m home alone with 2 kids under 3! They still haven’t covered a Dex, either, so it’s not like I could catch the lows early enough to be semi-functional overall.

[Michel]

@Pianoplayer7008

This is what is bothering me the most. I cannot risk multiple lows while I’m home alone with 2 kids under 3!

Now that is a pain, you are right

I know a way where you can get a month or 6 weeks of sensors, if you can borrow a Dex somewhere. Possibly you could get a “trial” where your endo could lend you one? Or possibly the Dexcom rep could lend you one for a few weeks? If you can get the dex, I can explain how you can get the sensors.

[Pianoplayer7008]

@Michel

If you can get the dex, I can explain how you can get the sensors.

Thanks. I’ll work on this for sure. I just started using a new cartridge of Novolog with my new pen, so I pretty much refuse to stop using it and switch to Novolin until the month is up (I can’t throw away good insulin!)…so I have time to figure out the Dex situation beforehand, I guess.

[Eric]

@Michel

if you can borrow a Dex somewhere. Possibly you could get a “trial” where your endo could lend you one?

@Pianoplayer7008,
All you would need to get is the transmitter battery. You could use it with your phone, so you don’t need a receiver. And I’ll send you some sensors.

There might be someone on FUD who used a battery for 9 months who has some spares…

[Pianoplayer7008]

Cool! I just got off the phone with my insurance, trying once again to get them to get a move on with approving one for me, so hopefully by the time I have to do the Novolin, I’ll be the proud new owner of a Dexcom and won’t need a workaround…

[Michel]

@Eric

And I’ll send you some sensors.

@Eric → I was going to “explain how you can get the sensors.”!!! I preempted you!

[Eric]

I wasn’t sure if you had a different angle.

[Eric]

@Pianoplayer7008

Now, insurance has denied coverage of Afrezza and, despite the fact that I JUST got prescribed and picked up Novolog, I apparently can’t appeal the Afrezza denial until I am on Novolin R for a month; basically have to show them a month of highs and lows to prove it doesn’t work. This is so ridiculous.

I have something for you. I am working on it now. I will post the details for you soon (it’s just a thing).

Two questions. Do you have a current script for NovoLog so you can keep using it? If so, you don’t really need to ever use the R. I will explain that in a bit

What kind of BG meter do you use?

Fill the prescription for R as proof you got it, but don’t worry about using it.

[Sam]

@eric is going to kill a gerbil?

Also mankind has a department called mankind cares that can help smooth out insurance issues and if all else fails provide discount cards etc…

[Irish]

Been trying to circle back to you all day with a meaningful message, but suffice it to say, this is rotten. Simply rotten, and we’re rooting for you all the way. Sorry I couldn’t manage something better than this. I was also hoping you had a current rx, so that you could use that while you “fail.” with measured lows that simply don’t work for you. But as usual, @Eric is fast! Love this suggestion.

[Eric]

I got a good one coming! It might be useful to you too!

Just have to finish and write it up.

[Aaron]

I have a feeling I know where thia is going…

I was going to post how I did MDI with R but not sure it is worth it

[Pianoplayer7008]

@Eric

Two questions. Do you have a current script for NovoLog so you can keep using it?

Yes! Just filled it a few days ago.

@Eric

What kind of BG meter do you use?

ReliOn Prime(?) - whatever the cheapo from Walmart is.

@Sam, we have gone through Mannkind Cares.

Thank you, @Irish!

[Michel]

@Aaron

I was going to post how I did MDI with R but not sure it is worth it

Please do! That would be great, different points of view are always great to read!