Afreeza not covered by insurance

At my last doctor’s visit, I decided to give Afreeza a try. Not for daily use, but for very occasional use with persistent high highs (above 240). My use might average out to once or twice a month.
I just got a letter from my insurance saying they denied coverage.
My question: should I pursue the insurance appeal route or buy some out of pocket? The GoodRx price is too high, but it’s for a large quantity (90 doses). Does anyone know if there’s a way to buy a small quantity or to get a better price? I have private insurance so I’m not sure if I’d qualify for all discounting programs but maybe I would. I don’t need it to be super cheap because I don’t plan on using it much, but I don’t want to spend the $450+ I’m seeing on GoodRx (but I would probably pay the approximately $5/dose that that price works out to if it were sold in a pack of 10 instead of 90)

Try looking to the manufacturer directly, there may be a much better price available than that GoodRx one.

You can always appeal, the doctor fills out the paperwork. But whether you’d win or not because you have other insulins available and they might not differentiate Afrezza as needed. I appealed Humalog years ago a couple of times when it wasn’t covered under an employer insurance and won, but I did have to pay a higher price as it was put at a higher tier.

Afrezza comes in different doses, and it’s not as strong as regular insulin. The 4 unit pack is more like 2 1/2-3 units. But it hits faster, more of it hits faster. Plus when you are high, it commonly takes more insulin after a certain point to bring numbers down. But I absolutely love using it. You do have to pass a breathing test before you can get it.

It looks like I haven’t ordered Afrezza since last July. I like it but I don’t use it very often.
Try calling Sterling Specialty Pharmacy at 888 618 4126
Open 7:30 to 5:30 CST

If they aren’t selling it anymore they will tell you does

You will need a prescription but do not need it covered by insurance. I ordered the 4 unit size and reveived 90 for $35.00

I don’t know if this has changed. I am on Medicare I used to be charged $90.00 making it still a good deal

Good luck

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