Several days ago I phoned into Walgreens for my insulin refill - 90 day supply for my insulin pump. Prior to the recent phone call I had a few problems in dealing with Walgreens, but somehow always managed to resolve them. This time it appears to have become more of a problem.
I received an email notification this morning that my insulin, which is normally billed under Medicare part B because it is used in an insulin pump, has been denied by my insurance. Since the same insurance dictates just how âearlyâ I can order the insulin, I am now down to my last vial and Walgreens is taking their own sweet time filling my prescription.
As a result I will need to go to WalMart tomorrow and see if I can buy a vial of their Humulin R. It has been years since Iâve used it, does anyone remember the particulars of this insulin? Also, does anyone know of a pharmacy besides Walgreens that bills insulin for a pump under Part B?
I get my insulin and test strips from Walgreens. I have seen the same letter from Medicare. So far all has been worked out between Medicare and Walgreens. I think the problem is with Walgreens.
You say that this insulin claim from Walgreens was denied by your âinsurance.â Are you referring to Medicare? Or perhaps your supplemental insurance?
When I called Walgreenâs they told me it was Medicare and referred me back to their Medicare helpline. Once I called them they wanted all the pertinent information they took down in 2015 all over again. On Facebook Seniors with Sensors group, someone has posted a news article about Pres Trump wanting to switch the pricey drugs like insulin from part B to part D which he can do without Congress. If he has done that then Lord help us all.
Was your claim successful or are you still denied Medicare Part B coverage for your pump insulin?
Yeah, I read the same comment on FB Seniors with Sensors group. I interpreted it as speculation, not fact.
I dealt with Walgreens on Part B test strips and the pharmacy technician kept telling me that âMedicareâ denied my claim. When I further pressed them for details, I discovered it was actually a Walgreens Medicare department at the Walgreens headquarters who was turning me down.
I get aggravated at Walgreens just about every time I go there. And here is why: Everything that I pick up for myself or my wife that I KNOW should have a zero co-pay, they try to charge me over $20 (usually $29) for. Their excuse is that they donât have a copy of my secondary insurance card. That is flat-out nonsense. They have had my card on file for roughly a year, but that seems to be their standard excuse. Their ineptness (or simply fraud) wastes my time as well as theirs, as I stand around waiting for them to fix the charge for the items Iâm there to pick up. Eventually, I get out of Walgreens without paying for something I shouldnât be paying for. Why they keep doing this is beyond me, but it is something I anticipate when I go there.
I used to go to Target but when they switched to CVS we were sent letters saying they wouldnât cover Medicare. So we switched to Safeway. That was even worse than what I described above regarding Walgreens, which is why we ended up using Walgreens. Iâd love to find a better pharmacy!
My local pharmacy for my CVS/Caremark Rx coverage is the CVS at Target. I have now received two 90-day Medicare Part B orders for test strips. The first time I made a co-pay but a few weeks later I received a refund through the mail of that amount. The second time I picked up my Part B strips, I left without paying anything.
I donât think they like dealing with Medicare Part B and I suspect they may lose money with these transactions. Sometimes I think they build in enough nuisance in order to discourage us.
agreed. I also think they didnât like filling my strips order for 1,400 for 90 days. As I understand it, they donât receive any more reimbursement for 1,400 strips, than they do for a far lesser amount, such as 300. Iâve seen the paperwork, and it appears to my UNTRAINED eye that is the caseâthe pharmacy is on the hook to fill the Rx for âxâ amount, regardless of the quantity, when it comes to strips. If anyone knows the absolute truth of this, Iâd love to hear it.
I also used to use 1400/90 days. Walgreens, under Part B, used to make me come back to pick up partial orders. I finally found a sympathetic pharmacist and she arranged it so that I could pick up the full 1400 order in one visit.
I cut way back on my strip usage and now only ask for 5 strips/day. They round up that 450 amount to 500. I find that sufficient with using my CGM when I know itâs tracking well.
Every single solitary time I have filled my insulin and my test strip Rx I have had to ask âwas this billed under part B or part Dâ because each time they tell me - âYour copay is $$$$â.
Terry, it has not yet been successful. They keep giving me the run around about âwaiting for my doctorâs approvalâ but I know for a fact that my script had 4 more refills on it. I called an independent pharmacy in another town and they quoted me $290 for one vial of insulin cash price.
Thank you for your understanding. I agree, it is difficult to see it as being anything but deliberate. I also have âotherâ prescriptions at Walgreens which I pulled out this afternoon and will fill them at another pharmacy in another town. Only bad thing is the ânewâ pharmacy doesnât not deal with part B insulin, but their prices for my other prescriptions are way more fair than Walgreens ever thought of being. Iâm so DONE with Walgreens except for my insulin and test strips.
I used Walmartâs Reli-on R and NPH right up until last year because I didnât have insurance. It works just fine, but you have to understand that itâs a very different mechanism of action. It supposedly starts working in fifteen minutes, but I never noticed that. It was more like two hours. You really need to plan on eating before the two hour mark. Itâs peak action works for another two hours or so, and then it starts winding down. It can linger a long time, though, but just at a very little amount of action. With R, youâre back to planning ahead of time how many carbs youâre going to eat. If youâre already eating, itâs too late.
I actually did pretty well on the R/NPH combo, though. Itâs great if youâre a grazer and like to nibble often instead of sitting down for big meals.
If you intend to put it into your pump, though, youâre going to have to make some tweaks. I take slightly less humalog than R per carb ratio. Youâll have to figure out what works for you, but I would plan on extending your duration of action (or whatever your pump manufacturer calls it) by at least two hours, and also reduce your basal slightly to account for that lingering action tail. Essentially, the extra bolus insulin youâll probably need is then subtracted from the basal rate, and it balances out in the end. There will probably be a tiny amount of the previous meals bolus still left in you as you go into lunch and dinner. Personally, I would set my nighttime basal back to normal about six hours after dinner, though, since thatâs the longest fast most people go through in a day and eventually that dinnertime R will wear off before you wake.
Of course, youâre going to have to test a whole heck of a lot to figure out what works for you. Good luck!
Edited to add here that I forgot about Râs âeat now or dieâ nature. It takes a while to warm up, but it hits hard and fast when it does. Make sure youâre always ready to eat when the insulin bomb starts ticking.
Oh, and youâd probably want to shift the scheduled changes of your basal profile an hour earlier. I saw you have a Tandem pump, too. Iâd just copy your current profile to a new one called âfâing Râ or something, then manually change each time segment to an hour earlier. And then set a temp basal for as long as you want for around 90%.
Just trying to get you started, but your mileage may vary.
Iâve had no problems with my local Walgreens. I did receive a notice from my distributor (supplies for my pump and sensors for CDM) that insulin would now be billed through Medicare Part B. I havenât refilled my insulin but I will see what the cost will be under Part B. Generally speaking I havenât had to pay for my insulin since Iâve been on the pump with Medicare and my supplemental insurance. Iâm wondering if it isnât your Walgreens that has a problem.
Iâve never bought insulin at walgreens. Just strips and lancets and misc. meds like antibiotic, etc as necessary. they never cease to try to charge me, as if I donât have secondary insurance. seems like they are trying to get away with overcharging, just like Safeway did to me. They ended up refunding me over $300 for their botched charging methods. Took me over 3 months to get my money back and thatâs why I moved over to Walgreens.
