I am about to lose my natural mind. My son was switched from Novolog which he was on since he was 13 to Humalog now at 26. First of all I’ve read there is a significant difference between Humalog and Novolog, and now they want 800+ $ for his Insulin. He cannot afford that. What is wrong with these people. Now he is stuck playing Russian roulette with Humulin from Walmart. I am scared to death bc he uses a pump and now this is by injection. He hasn’t used injections in probably 10 years. What do you parents do in situations like this?
The Humalog help site where they supposedly help you pay, didn’t do shyt.
His only bet is Canada, however he has to get his passport which will take just as long. My worry for him never ends.
Someone please give me some idea that I haven’t already exhausted.
Thank you all.
Hi Winter
Just to clarify, was the switch made by your insurance company or endo?
You can probably get that approved if your endo will work with you on an appeal. If he won’t, you shuold get a new endo first.
I can help if you want to appeal it.
Is the issue that you don’t want to try it or that it costs too much?
But before you do anything, have you tried Humalog in the pump yet? It may not work as well for some people, but it has the same basic onset and duration as NovoLog, so it would not be risky to try it.
Also, as another option, you can get either Humalog or NovoLog shipped from Canada for much cheaper than $800.
But let’s work through it. I’d be happy to help.
Confusing.
Would you be able to elaborate?
@Winterprincess, Welcome, this sounds like a very stressful situation, for that I am sorry. To answer your questions in no particular order, injections are a skill and that is why our endo politely asks my son to take a pump break for at least one month per year, because these things happen unfortunately. If your son needs any help many here would be willing to walk him through skills he may have forgotten. The Humalog/Novolog switch is pretty common for insurance companies to pull, and so many here have experience with this switch, and most (not all) are able to switch 1:1 with little to no difference in usage. The $800 sounds like a list price, is this because your son had to drop off your insurance? Does he have insurance of his own? Btw - if you get a prescription for the insulin from your endo, you can mail order insulin from Canada. Just search our site for the threads. No need to get a passport.
My insurance switched me several times between these 2. I use pump, and they were almost identical for me. A slight difference was that novolog kicked in a bit faster, so with humalog I had to wait longer before eating.
I have heard many others report similar experience, a few saying humalog required slightly higher total daily insulin.
Is the humalog $800, and novolog not available at all ?
Is he on employer healthcare ?
Sure!
He was switched to Humalog and has been using Novolog for years.
Insurance covers a certain amount and his amount is 800, YES! you read right. $800.
Who switched him and what was the reason for the switch ?
MM2 He has health insurance through his job, but it goes through Kaiser Permanente.
Chris He has his own insurance and he has been off our insurance for years. It was a whole heck of a lot more if he didn’t have insurance.
I thought it was much more expensive to mail it.
Thomas His assassinine insurance company, HUMALOG IS apparently cheaper. (Not that I recall)
In order to get back Novolog, he would have to prove medical necessity. Not to mention wait 14 days on top of the decision.
It was totally the insurance company.
I’m just at my wits end. I can’t believe the " if you can’t afford your medicine coupon" didn’t work. Wth?
Even good RX was a waste.
Question, may be dumb, to fly to Canada can we use our real ID like we can if we drive?
Mail from Canada is certainly an option other people have done.
You don’t need to go to Canada. You can get it delivered by mail. That’s the easier way. You just need a prescription.
But really, the insurance appeal is not hard.
He may be able to use this novolog savings card, if you can get it switched.
I paid $75 per 90 day supply while on my employer plan.
This amount may go down once deductible is met. And with that amount may be met soon !
My current insurance costs me $288 per vial, before my oop maxed out.
(A drastic change from $4 per bottle in 1970s)
The Fiasp vials for us are almost the same @ $281 before the yearly deductible is met. The deductible resets on January 1. We usually have the deductible met by mid-February and then we pay 10% of the cost according to the insurance contracted/negotiated amounts.
Both the deductible and the additional 10% ongoing charges then go towards our family Out of Pocket Maximum.
If/when we hit our family Out of Pocket Maximum then there are no further costs for the remainder of the year. At least the last three years we hit this by mid-year.
What is helpful for us is all costs for all family members contribute first towards the deductible and then towards the Out of Pocket Maximum. All family members, all prescriptions, all doctor charges, all hospital charges. There are no separate buckets for us as there are on some insurance plans.
@Winterprincess - What does the $800 cover? Is that going towards a deductible that would be met? How much insulin does that provide? (ie - particular number of vials or one month’s worth or different amount?) If you had approval from the insurance to switch back to Novolog would the cost through insurance for the insulin be different? Do pump supplies also count towards a deductible?
I use this savings card and it works like a charm! I pay $25.00 month for my Novolog rx.
Although I don’t think the insurance company should be making medical decisions, that’s how it is here in the USA at present.
My insurance switched me from Novolog to Humalog, and for me it works the same in my pump, so I went along with the change rather than trying to fight it.
I think it’s good for 2 years. I used it for 18 months before I ended my employer plan.
Right now my insurance covers Humalog which I actually prefer. But a few years ago they tried to switch me to Novolog and all I had to do was try the Novolog and tell the endo I didn’t like it as well so then my endo wrote the insurance company saying I had to have humalog as it worked better. Which she did and it was approved.
He should be able to appeal it easily by him just calling his insurance company and starting an appeal and the endo can send in the paperwork for it. But at that time I did have to pay a little more for my preferred insulin as it wasn’t the accepted one.
The insurance companies bargain each year to supply the one they get at the cheapest price so I don’t really blame them for that. Consider how much the manufacturers are charging for insulin in the US. A lot of different countries that have government run health plans limit which insulins people can get because of pricing too.