MDI and Copays

I've been pumping for the past 4 years and thinking of going back to MDI do to the cost. My question is if you take 2 different insulin's with on MDI does each one have its own Copay? Or do you have one Copay for both?

That is an excellent question. You have to see what your insurance coverage says. Usually each prescription has a copay, so probably you will have two. Let us know what you find out.

Yes, there are 2 copays typically since it is 2 medications. Apidra probably has a secondary copay card available through the end of the year, and they might continue it.

Unfortunately a copay (if you have one) is due for each separately billed service or product. The biggest difference between insulin coverage with a pump versus MDI is that under the pump insulin is sometimes covered as Durable Medical Equipment (DME) which has a different coverage than prescriptions. Some insurance follows the lead of Medicare which makes this distinction.

I don't think it's any more expensive to pump than for MDI. A vial of Lantus is about 210. Vs 110 a box for Infusion sets (10 a month) + another 20 or so for the reservoirs.

Well, the copay will cover most of the cost so adam would not pay 210. Many folks doing MDI don't use the vials, they use the pens which are more costly. Vials would be two copays, and then the syringes would probably be another.

I can get a 90 day supply of insulin pens for a single co-pay when I order through my insurance mail order.

Is that a single co-pay for two different insulins? adam will need base and rapid insulin.

If your total daily dose is low, then pens can be much cheaper. If you use less than a vial of an insulin per month, you'll be throwing more away with vials. Each pen has a 30 day life so if you use about 1 pen per month, you get 5 months out of a single co-pay...


No, that's full price. The pens are about 300 a box.

I pay a separate co-pay for my humalog and a separate for my Levemir. But I save a great deal by ordering a 90 day supply.

It is very unlikely that any insurance carrier would let you pay a single co-pay for a bunch of different prescriptions.

I know, or at least suspected that was the case. That is why I asked, Brian. Your earlier reply did not indicate this little factoid.

yeah. I was on MDI years ago and I remember only using like 1 a month. I had a fridge full of pens. I think I did have 2 copays for the 2 types of insulin

A lot really depend on your individual insurance as to cost and how you do things. Again, a lot of drug companies are doing a 'secondary copay' where they cover your copay. Right now Apidra has a no copay savings card.

hopefully your copay is minimal. As others have said it is really economical to get the 90 day supply if possible.