I have United Health Care and they are forcing me to get all my prescriptions through their mail-order pharmacy OptumRx. Well, I could pay 10x as much to fill at a local pharmacy but yeah… that’s not really giving me a choice now is it?
For some medications where there isn’t a lot of change in dosing, this isn’t a problem. I take a pill a day, I’m going to continue to take a pill a day, so sure send me tons at once. But it’s been causing me a ton of grief as I’m new insulin, my doses changes every 2-3 months, I just moved to a CGM (changing how many test strips I need), and now I’m on a pump. So paying for 3 months of something I probably won’t need in a month, is nuts.
This time around, they are taking their sweet time filling my new prescription for vials of Novolog as I just switched from MDI to a pump. They won’t let me fill my current prescription for pens because they are in the process of filling my new prescription for vials. I’m down to just a few pens, and am MacGuyvering insulin from the pens into my pump. I really wanted to save my pens, for a backup or pump breaks but now I’m down to 10 pens, and am not even sure I won’t go through them all before the vials arrive.
Last week I called and said “Don’t send me anymore pen needles, test strips lancets or Levemir” because of the switch I didn’t need them, or didn’t need them in the quantities they are currently set to. With a mail order pharmacy, they won’t let me say say “My prescription is for 11 boxes of strips per month but this month, money is tight so only send me 3 boxes instead of 11”. I canceled well in advance, but it didn’t work. Friday I got a bunch of stuff that I didn’t want to pay for and in some cases (Levemir) don’t use anymore.
I miss being able to go to a pharmacy, talk with the person and get just what I need, the same day I need it. Waiting 3 weeks for my insulin is stressful. My husband previously always had Blue Cross Blue Shield and is seriously considering switching jobs just to get the better insurance back.
I agree with @Sam19. All’s fair in love, war, and dealing with pharmacy benefit managers!
If you find your supply outstrips your needs beyond a comfortable buffer, then simply delay ordering the next 90-day increment until your excess returns to a reasonable buffer amount. Doing this returns control to you, where it should be.
Dealing with the daily burden of diabetes is already hard enough without having to navigate endless phone mazes, talking with underpaid-clerks who don’t understand diabetes, and pharmacists who think insulin is a commodity – interchangeable from one brand to another without consequence to the diabetic.
Get what you need. Develop a comfortable buffer to shield you from an immediate health crisis if your workplace benefit changes, or you find yourself out of a job and the health benefits that keep you alive.
Yes = I’ll join th echorus. I have UHC and have to order my insulin via OptumRx – My doc has, thus far, made sure I get more than I need, so I’ll not run out. Insulin, once shipped, arrives overnight - They HAVE to ship it that way, because it has to be on cold packs. Fortunately, I’ve been able to order my other supplies from pharmacies other than OptumRx - most by mail, but still a lot easier to manage than OptumRx has been. I stopped buying pen needles via insurance long before i went on a pump, because UHC’s “discount” in my case was not worth the trouble.
On thing I have managed – my prescription for insulin has continued to be for PENS, not vials, even though I am on a pump. UHC has covered them, and I happily extract the insulin from the pens for my pump (Actually, I PUSH it out, rather than draw it out - works better!) – that way, I always have pens available for backup. My endo keeps thinking they’ll stop the order, but so far, it’s been no problem…
smacks forehead I never thought to get my endo to prescribe more than I needed to build up a buffer! I like the suggestion to manually request when they send my scripts, instead of auto-ordering everything every 3 months.
Thank you, I’m seeing her on the 9th and will get my scripts updated.
Oh yeah auto refill would be a nightmare with insulin and supplies but it’s great for a 1x daily pill.
I have mine on auto-renew but manual refill… so when the time runs out on an rx they automatically send a renewal request to my doc but I have to actually place an order to get them to ship it.
Main hassle I have now is getting them to ship cold packs to my po box now, which requires me actually speaking to a human being and then doing a “manual refill” to override the computer systems requirement for a physical address (post office doesn’t deliver to physical addresses where I live)
When I lived on my sailboat I received my mail at a PO box. Several years ago the Post Office decided it would allow delivery of UPS and Fedex boxes to my post office box. I had to sign a post office form to authorize them to sign for me if necessary. They told me to alert the shipper to use the street address of the post office and instead of the “PO box” #, just insert the number as if it were an apartment or condo number. It had this format:
My name
1234 Main Street #5678
Anytown, CA 94128
(1234 Main Street is the street address of the actual post office and #5678 was actually my PO box number.)
As long as I gave the format above to my shippers, they would ship and I would receive it. Since I didn’t live in an extreme climate, I was confident that if the insulin were stored for a day or two at the post office, it would not freeze or be subjected to high ambient temoeratures.
I feel your pain. I hate mail order. Fortunately for me, at least for now, I only pay a couple dollars more at the local pharmacy. Worth it to avoid the hassle. Especially for insulin.
That would work if they were willing to ship it ups or fedex… but as far as I can gather they cant or wont do that to Alaska… their computer system just insist on having a physical address that the usps can deliver to-- maybe I can start giving them the post offices address even though its already the usps sending the item, just to trick their system.
It isn’t too much additional hassle to get them to do a manual fill— and they have it noted in my account now how to do it manually I just have to call and wait on hold a few minutes to get a live person
I would approach this topic carefully with your endo. I suspect not every endo will buy into this. I think many of them are sympathetic with this so they will cooperate. I would not plainly make a request for “extra insulin” so you can develop a buffer. I would simply request, “I need X units per day and will need some insulin to cover what goes to waste in the infusion sets and such so please order X + 10 units per day.” So if you actually use say 40 units/day, request the endo write it for 50 or 60 units per day to cover the waste.
What I’m trying to say is that it may go easier if you’re not explicitly asking for extra insulin but will need more than your actual daily use due to a “fudge factor.”
Contact your endo/CDE/pump nurse now about getting insulin to cover the pharmacy delay…once they know about the problem they can insure you won’t run out waiting. Mine has given me emergency humalog and lantus when needed for free. As your endo adjusts treatment and changes scripts you need to outline you currant supply status…
I get that—When I was first handed my T2 dx a decade ago, all my doc did was hand me some pamphlets with a lot of happy people pictured----when I was raging in despair. I took out every book in the library and bought every used book at Powell’s, studied up enough to know I needed a meter. At that point—my pharmacist became my CDE—he was a T1 and taught me so much. TuD was my next teacher. I love my pharmacists and would miss being able to interact with them…even though I have found a new and very supportive doc…
One other piece of advice with OptumRx – take advantage of their bureaucracy. They only promise “5-day shipping .” – which of course isn’t true with insulin (it ships faster). BUT - because of the 15-day thing, they actually allow scripts to be written for 100 days, rather than 90, AND, they allow you to re-order after 85 days. ALWAYS reorder on day 85 - that way you squeeze an extra 60 days out of the year! Seems silly, but it’s helpful to make sure you don’t run short.
I have United Health Care Rx program and since I have a pump, my insulin is under Medicare PartB—Walgreen’s is amember here in FL, check with United again & ask what other local pharmacies are on their approved list. Maybe Costco is even cheaper??? Shopping around is always a good idea though it takes time.
