Good News On Express Scripts Appeals Process (Formulary Changes)

When I posted an earlier discussion about Express Scripts rejecting my four year old son's valid and covered insulin prescription at the end of 2013, Emily "Sweet But Still Awesome" Coles said ES contacted her with an email address to help. I didn't use it at the time because our endo was in the process of fixing it.

Now this year Novolog and Freestyle test strips were taken off our formulary, both of which we really need. (We've used Humalog and it didn't work for my son, and we use the Omnipod which requires Freestyle.) I decided to try the email address for help with an appeal.

I have to say - ES was very responsive, helped, and approved our appeal with minimal delay and fuss. My original appeal email was answered in 14 minutes to say they were working on it, and they would contact my endo for confirmation. I was also surprised with the quick response since my email was pretty long and detailed explaining our medical need for both items. Two days later I received an email saying my appeal was approved, and I had access to these medications for another 12 months. That's it, problem solved. You could have knocked me over with a feather.

I would encourage anyone struggling with Express Scripts or who needs help to use the email address - Let us know your experiences too.

AWESOME. I am SO happy to hear this.

GREAT news! I remember reading your posts and it made my blood boil. So happy you got resolution, just sorry you had to go through all that.

Thanks everyone. And hopefully this helps someone else too.