I posted this elsewhere too but, just been informed Novolog is not on the Silverscript Plus plan for 2025, which is being .merged to the Aetna Choice Plan. And if you use Omnipod 5 via Silverscript Plus, one of us is being told it’s not covered when another customer service person says it is. Currently Tier Three which is being done away with I guess. So fun, Medicare makes life so fun…strong text****Silverscript and Aetna in general will no longer cover pods. You can request exceptions but pay more according to Insulet as it will be tier 4 and non formulary.
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Aetna says the 2025 plan docs will be available October 1. Save the work till then?
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Ive got the 2025 handbook. No Novolog vials at all. Pods still questionable.
The Aetna 2025 formularies are available. I used View Aetna Medicare Coverage & Benefits | Aetna Medicare to get to them. Looks like they have at least 2 Silverscript formularies for 2025 depending on what state you are in. I checked the one for California and the insulin list says to me “T1D go away”. I hope you don’t have too much trouble finding a different plan that works for you.
Go Away! Exactly. Insulet says Omnipods no longer covered unless you go to Tier 4 and file exceptions, which she told me will not make them formulary in any way. Novolog at 70/30 mix? Humalog generic only? No. Stock up the rest of the year and find a new game plan ASAP I guess.