[Diabetes-Talk] Questions regarding insurance, and insulin pens

[Terri Stimmel]

Hello everyone,


I don't know if anyone here will have any thoughts for me. What I have 
to ask is rather complicated. I am hoping though that some of you might 
understand this, and might have some advice. Or at least know where to 
direct us.


Ok, my boyfriend has type II diabetes. He receives SSDI, and is on 
Medicare. We live in the state of Missouri.

Right now, he is not on Medicaide, because the last time he applied, his 
spend down amount was going to be around $600, or 700. So he decided to 
not get the Medicaide, as that would have been about half his income.


well right now he is trying to decide as to whether or not he should 
stay with the drug coverage plan he has. Which I believe is Signa Health 
Spring, RX. He goes through a broker to try and decide what plans might 
be best for him. He has had to use different insulins over the last 
couple of years, due to the price. He wants to stick with the insulin 
pens, because these work best for him. Due to his limited vision, and 
other things.


However, the lady who has been helping him to figure out if he should 
stay with what he has, is telling him that nobody will cover the current 
short-acting insulin he is taking. I doubt I will spell this correctly. 
But it's, Epedra. The only reason he is currently on this is, because 
his doctor's office was able to somehow get him in to a patient 
assistance program. This covered that medication, and Lantice.


Well, he has looked at Novolog, and Humalog to see if he could possibly 
take 1 of these, and maybe go back on Triceba for his long-lasting 
insulin. while he could get the Triceba for a reasonable price in the 
beginning, that's not at all how it is for the short-lasting pens. And 
apparently, according to the information we were given, there are only 3 
short-acting insulins that come in the pre-filled pens.


Anyway, with any of these 3, they seem to be anywhere from $700, to 
maybe $300. I might not be remembering this exactly right. But this 
would be the sort of prices we would deal with, until he reached the 
doughnut hole, as some call it. Also, he could get a low premium cost, 
but have a high deductible.


As you can imagine, we don't know what to do. He feels at a loss. He 
needs the insulin. His diabetes isn't real well managed as it is. He is 
considering seeing if he could go back to using viles, and just getting 
help keeping syrenges full. But we don't know if this would be better, 
or cheaper. Although a nurse at his doctor's office did say that the 
pens are more expensive.


Does anyone else deal with all this? How do you all manage the cost of 
your medications, especially the insulin pens?

He does take other medications as well. But these are pretty affordable.


Any thoughts and suggestions would be very much appreciated. Sorry for 
all the mis-spelled words. I hope you all will get what I am attempting 
to say.


Thank you,


Terri