For the first time today I had problems at the pharmacy getting enough insulin to cover a month. They tried giving me 1 vial, which is about 20 days (insurance for 30 days) then two vials for 40 days (insurance for 60 days). They stated giving me 2 vials for 30 days is insurance fraud, but how is it fraud when there aren’t smaller vials. The problem is I would always be behind with insurance because they allot on 30 days. Have any of you ever had this problem and how did you fix it?
I am a pen user, but have a question,does your doctor write how many vials/ dosage information on your RX? If providing both would that help if it isn’t being done. Nancy
That’s nutty that the pharmacy personnel said it is fraud to give you correct amount of insulin., Time to change pharmacies. I had trouble years ago with Longs Drugs, so they lost my family’s extensive business permanently. I have better luck at Target which is both close by and rarely too busy that I have to wait behind another customer. Sometimes I’d wait more than 15 minutes to get to the head of the long lines at Longs (now it is CVS). Maybe that’s why it was called “Long’s”—for the long waits.
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I have to place some of the blame on your doctor. You should always clearly explain your situation so that you can a prescription that covers your need. Explain to your doctor that his prescribing practice is causing you to go 10 days without insulin. Ask him if that is what he wants you to do. If he really wants you to have the insulin you need then he needs to prescribe “properly.” You need 2 vials for 30 days.
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Hi Erin,
I hope you will call your doctor and ask for your RX to be corrected. I don’t know where you live or what insurance you have but I do know that the prescription needs to say how many units per day NOT how many vials per month. For whatever reason (good or bad) that is how the pharmacy determines how many vials you will receive. I know it is stupid but it’s necessary and if your doctor isn’t aware of how pharmacy systems work today then I’d even consider getting a new one. Also, I agree with pheonixbound, even though you didn’t ask and would also consider getting a new pharmacy - one that did not accuse me of insurance fraud.
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I’ve found that my doctors want to help me get the insulin I need. In the real world, there is always some insulin waste. Like the waste in the insulin left in an infusion set when it’s removed. Insulin manufacturers say to discard a vial 28 days after first use. If you don’t use a lot of insulin, this causes waste.
Here’s what I do. I figure out how many vials (pens or whatever container) I need for a month. For example, if I need 2 vials per month, I know that there are 1000 units per vial. So, I divide (2 x 1000) by 30 days = 2000/30 = 67 units per day. Then I ask the doctor’s office to write an order for 67 units of insulin per day. This concrete order doesn’t allow for any creative corner cutting and gives you the insulin that you need to live. And it doesn’t require any judgement on the part of the pharmacist or their technician.
In my sense of an equitable universe, any rounding goes to the benefit of the person with diabetes. If you need 1.5 vials per month, it’s not your fault that Big Pharma doesn’t supply in half vials. Then you need two vials per month! Then perhaps the pharmacy should entertain a 90-day order. Then you’d need 4.5 vials, which would then round of to 5 vials and only a 1/2 vial waste over 90 days.
What’s wrong with having an extra vial of insulin on hand? You could drop a glass vial and break it. I once lost several vials to a refrigerator that malfunctioned and froze my insulin. Why should you have your life threatened because of the typical vagaries of life?
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Thanks all! I thought this was crazy. In the past I always got a full bottle for the amount even if my dosage means I only need half a bottle. It was really strange and the first time in 20yrs this has happened. I will have my doctor fix the prescription so this doesn’t happen again. FYI this was at a CVS pharmacy.
The problem could also be on the insurance side. My daughter’s endo has always written the Rx “up to 100 per day.” This gives us 3 vials per month. At one point, she was actually using that amount. When our insurance changed in May, we were limited to 4 vials every 90 days. When I called them to straighten it out, I was told that was the coverage limit for the plan. We can fill the Rx as we’ve always done, but we have to pay the difference. It’s an employer-sponsored plan. There is no override or other loophole. Last month, they changed the plan limits on test strips. We’re now limited to 150 strips per month.
I had this same problem. the problem did not originate with my pharmacist it was with insurance coverage. My pharmacist recommended that I fill it every 20 days which was allowed but that meant another copay and more money from my pocket.
I solved this in the manner every one has recommended. I ask my doctor to re-write my prescription to be only in full vial amounts.
Brain is right it looks like a doctor issue. Doctors prescribe insulin in two ways. The numb ro days per day and the other the number of U per month. Doctors often say x U per days and a different number of vials The two have to mesh
Hare them recalculate and send it in.
rick
I didn’t read all the comments so if someone already suggested this I’m sorry. Why not have the doctor prescribe 2 bottles every third month and continue one bottle every month? If you start with 2 you will have some left over for the next month added with the one you will get monthly. If that is enough to last until the next 2 bottle time. Will that work?
That requires the pharmacy and insurance to do extra work in determining which month you’re on, something they are notoriously averse to, IMO.
It is really so much easier to get the prescription re-written to ensure there’s a bit extra. This also insures you against all the variables of life - pharmacy closed/out of stock, car breakdowns, dropped vials, etc, etc.
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