Hi, Sherry Ann,
Thanks for this very complete response. I’ll just mention that the use of Optum Rx is not optional.
Your explanation further illustrates how the experience that each of us has with T1D is unique, yet we can help each other with experience gained from use of different insulins, different pumps and different settings. It sounds to me as though your vigilance and watchfulness around mealtimes are not exactly what the pump manufacturers tell us: "Makes life simpler!"Happy that you continue to take care of Sherry Ann.
This was so interesting to read the different coverages. I was looking at switching to FIASP due to Part D plans. I currently am MDI and use Novolog. However, decided to stay with Novolog and in my part of the country (Southwest) my best option is an Aetna plan called Silver Script which does cover Novolog. It’s not just the plans but also the areas of the country
Yes
Get the generic instead the same everything a little different package but the same and hundreds of dollars cheaper. Thru Medicare I get a 90 day supply 9 bottles for 35 bucks. Look into it
I used fiasp before i had my tandem pump when I was on mdi. Fiasp is an amazing nice insulin. When you bolus you don’t need to wait, don’t ever wait, eat immediately. If it’s a low glycemic food or your BG is low finish your meal then after that bolus. Fiasp Novolog conversion is 1:1 same. The only difference is the speed of it. I hate waiting 20 minutes after bolus to start my meal on Novolog but since tandem is not approved with fiasp I can’t use it.
As far as I know omnipod is approved with fiasp, so you should have any problem. But you can always check their website or email them to ask whether 3 days is OK or not with fiasp. I read people on tandem pump attempted to use fiasp and they had occlusions, but it wasn’t approved to start with. By the way the fiasp will lower your BG faster and the effect will be less, it’s very close to human insulin reaction timings. So you don’t peak too much after meals. But remember the advice about low glycemic food. Since the exposure time to higher BG is reduced your A1c should improve in theory. The only real difference of fiasp is that it has vitamin b3 in it for faster absorption as far as I remember compared to Novolog. Both are insulin aspart and initially fiasp was twice more expensive but now should be the same price and my copay is never more than 35$ for any insulin with the new regulations anyway. If your Copay increases just go to novo nordisk website and download the savings card (for private insurance users) and your copay amount will be reduced to 35$ per month. My insurance doesn’t even cover fiasp anymore, so as backup i got lyumjev which is another ultrafast insulin similar to fiasp, I never used it, just in case my pump fails I’ve it as pen form. I’m still on Novolog with my tandem pump.
I used Fiasp for several years while I was working and had a medical plan that covered it. I absolutely loved it, it worked well in my Medtronic pump, and I got better results than I did with Humalog. Unfortunately, now that I am retired, I am on a government medical plan and they will not cover Fiasp so I am back to Humalog.
I had SilverScript for years with no trouble with drug coverage, then Aetna bought them out and problems started. However, since MY SilverScript plan no longer covers Novolog, I have had to go elsewhere. Please just double-check that your SilverScript plan from Aetna still will cover Novolog in 2024. If it does not have it listed in the 2024 formulary, they can charge you full price for the drug. I was quoted a price of over $41,000 for out-of-pocket costs! As mentioned above, I switched to AARP Medicare RX Preferred for UHC (PDP). Finding the right plan to cover your needs takes some time, but it is worth it.
1 Like
I have been trained as a Medicare SHIP counselor and have definitely checked that ALL meds are covered. As I said, it definitely seems to make a difference in different parts of the country.
1 Like
While not a great price compared to Medicare covered insulins, for $70 you can get Fiasp 100 ml vial from Canada. Before getting Medicare, i purchased a years supply at a time in winter month from Canada when Novolog was $35/vial (vs hundreds in states even with insurance). Marks Marine Pharmacy (https://canshipmeds.com/) was excellent.
1 Like
[the content of this post has been deleted by the author]
I talked with my Endo and decided that Fiasp would not work for me. I know that Fiasp is just an upgraded, faster working form of Novolog, but that is the problem. My digestion has slowed way down, so for me to use Fiasp, I would have to totally retrain myself to eat and count carbs, wait about 2 hours, and then remember to take my insulin. But then, do I just base it on the carbs, or do I base it on what my blood glucose is at the time? And if I take the Fiasp too soon, I run the risk of really dropping low since I am super sensitive to insulin. (Even after a heavy meal, my dose still will only be 3 - 4 units.) We decided that the risks of dropping low or of me totally forgetting to take the insulin since life goes on once I have eaten a meal were just too much bother. I know that Novolog works for me, and I was able to find a new drug program that covered it all. As for the O5 always fixing what is going wrong, I am starting to be disenchanted with that, too. It lets me get WAY too high before it starts to kick in and give me insulin, and then, of course, it takes way too long to actually work. I think I have a plan now that works for me, so I will stay with the new drug plan and the old Novolog for now. We’ll see what the new year brings.
1 Like
contents removed by original author
I think you are referring to iLet from Beta Bionics, the stage 5 insulin pump which is available since June 2023 if i remember correctly. It just requires you to provide your body weight and announce meals, without carb counting as you already mentioned. I am not using it, but it sounds great, once it is further improved. It is even integrated with Dexcom G7 since December 18th.
I am still on Tandem X2 with Dexcom g7 and my a1c is between 5.3 and 5.6. I am on Novolog for the pump, but used fiasp when I was on MDI. for me Fiasp was a game changer, no need to wait after bolusing to start eating with the Fiasp. But with Novolog i need to wait usually (20 minutes?). Yes they are the same insulin but fiasp has added vitamin B3 to increase the absorption and is much better than lyumjev (lyumjev caused horrible rash and wound in the injection area for me). I will ask my endo to prescribe me fiasp again as back up insulin in case of pump failure or when not using the pump.
If they would allow the iLet meal announcements from the mobile app and decrease the target BG further down to 100 it would be my choice. But for the moment it is not possible. I do not like to interact with the pump when i want to eat.
1 Like
[post deleted by original author]
In fact they use a completely different algorithm - which they believe to be superior. Whether it is or not, who knows without trying both and comparing. And there is a ton of information available on their site, including all their iLet pump documentation, that can be read without entering any info at all, let alone insurance info.
Parenthetically, here you are again deleting all your previous posts, even the earlier ones in this same thread, confusing the conversation and making it really unclear what your point is. Do you care to give an explanation of why you do this?
for the moment even with iLet target BG set to 110mgdl it is maintaining 120-130mgdl, but I have only asked a friend to check it out with meal announcements. I have not used it myself. The GMI was 6.4 with iLet, and NO Lows ever. Just 4-5% high on the TIR with 95% of the time (70-180mgdl). Thats great actually. But i need lower values (100-110 average BG) and my current GMI is 5.9 while a1C is 5.5. with a TIR 99% (70-180) in 30 and 90days. Still trying to improve it but with the restrictions of the Tandem I am able to do only so much. I wished the CIQ would allow a target BG setting of 100mg dl and lower BG threshold could be user modified. That would improve everything.
I did not know that you can ship insulin from Canada. Is that still the case?
One year later. Sherry, I am a caregiver for a homecare patient IDDM injection, not pump. His Medicare part D is Wellcare and it covered Fiasp, not Novalog, and got a prior authorization on the Novalog for 2024. We were not ready to try FIASP because the insurance was already causing us to change his long acting insulin. Now the new 2025 Medicare part D , from what I can find, do not have novalog on the formulary, Including the Silverscript. He is on an extra help for financial reasons from the state and there are only 3 insurance providers and none of them have novalog covered but I believe you can continue to get a prior authorization. Have you found a plan that is covering Novalog on the formulary for the 2025 year?
We switched from CVS and SilverScript to AARP MedicareRX from United Healthcare and Walgreens for Novolog coverage. If he is on low income assistance, though, I would imagine your choices are quite limited.
You should be able to. I used Mark’s Marine Pharmacy. They know all the ins & outs of customs, keeping insulin at proper temp, and easy to ask questions /talk. [site] (http://www.canshipmeds.com/)
More of us on Medicare may need Canada or Mark Cuban’s site. Major pharmacies are considering not carrying certain cheaper drugs.
From Axios: " More than half of independent pharmacies are considering not stocking the first 10 drugs that were subject to Medicare price negotiations over concerns they’ll have to absorb upfront costs." For example, Walgreens gross profit in 2023 was only $27 billion. Hard to get by on so little.