Any news? I sent Humana my latest 90 day refill for vials to use in my pump and so far nothing seems to have happened at all. Their online page of my acct still says it’s due to arrive yesterday.
What are some of you other users of it hearing? Mostly I’m curious what Humana might do if I get closer than I am now to running out.
I’ll ask them of course but I always like to hear from others here
too.
A shortage of Novolog was reported last year.
Yep, pharmacy just told me it was backordered, too. Couldn’t get a single vial. Luckily I’m okay for a few months, but my spare supply really got impacted when I having insurance issues a little while ago. Feeling kinda nervous since I’m allergic to Humalog.
Kroger gave me a three month supply of my usual two monthly vials so I don’t know?
CVS. has shorted my victoza from 3 pen per order to two pens. My Novalog went from 5 pens to 3
I just got my regular 90 day Novolog scrip filled, later than Humana usually takes, but it’s here. I don’t know why it worked the way it did, though. I got all 4 vials, as usual, and the total cost before insurance is only $278.81! My 20% Part B copay (I use it in a pump) is just $55.76. I’m not complaining but I’m sure surprised! Did Novo Nordisk decide to cut their prices? Did Humana manage to snag some deal with Novo Nordisk? Whatever. I hope my good fortune extends to the rest of you too.
Both Novo Nordisk and Lilly are producing generics of Novolog and Humalog. Medicare filled my Novolog Rx with generic insulin aspart. It is the same as the branded products and produced by the original manufacturers. They really got their hands slapped recently over excessive cost and agreed to the $35 max per month. Now they have a cheaper generic. It’s just the same as the original. Don’t know if there is anything up their sleeves for the future but am happy with either one.
Yes.
I’d like to know what happened to my being able to get my pump insulin at no cost through my Medicare Part B -DME, which I had been getting for 3-4 years. Now, since the $35 insulin limit, I am paying for my insulin. Did that new law affect people getting their pump insulin at $0 cost?
My 90-day supply of pump-delivered insulin that I picked up this week with $0 copay was made possible by my Medicare Part B-DME coverage along with a supplemental medigap policy. I’ve been doing this for years.
As far as I know, the new $35/month insulin Medicare Part D limit does not affect the Medicare Part B-DME insulin policy. Sounds like the cogs in the bureaucratic machinery got confused.
On July 1, 2023 the OOP (out of pocket) cap of $35 for Part B began. According to this Medicare document in Section 4: “If you have Part B and Medicare Supplement Insurance (Medigap) that pays your Part B coinsurance, your Medigap plan should cover the $35 (or less) cost for insulin.”
So either your Supplement Plan doesn’t cover the Part B OOP or your pharmacy didn’t bill correctly for your insulin. I’ve also read of some pharmacies incorrectly making the customer pay the OOP at time of pickup thus forcing the customer to later get reimbursed by the pharmacy.
Like @Terry4 I have continued to received my pump insulin for no OOP.
Thanks for that clarification, Laddie. I didn’t realize that $35 limit also applied to Part B-DME insulin. I think I’ll call my Medigap plan and confirm that it covers the $35. When I signed up with this insurance company several years ago, I understood that it would pay for 20% piece of my insulin cost except for the annual Part B deductible. That deductible is $240 in 2024.
A further search repeats a source that includes the same wording that “your plan should cover the $35/month” cost. Should??!
For those of us getting insulin through Basic Medicare Part B and a Supplement Plan, we shouldn’t see any change in our insulin being received at no OOP. But people without Supplemental Plans and many on Advantage plans might see a huge cost saving if they were previously paying 20% of the cost.
Well, its good to know you got a 90-day supply. I still have problems getting my 90-day supply of 15 vials (yes, I require a lot!). I just picked up only 5 vials (a 1-month supply), the remainder of a previous RX at my pharmacy. And it was through Part B-DME, so $0 cost. I have plenty now for awhile now, so I will cross this horrible bridge next time! Still frustrating!
Question about what you wrote re insuline aspart generic. Wellcare had Novalog off the formulary 2024 got it prior authorization. FIASP was on the 2024. Now, on the 2025, Both novalog and fiasp off the formulary. WHen I called and asked them what WAS on the formulary, she said " insulin aspart". When I asked her how does she know that it is insulin aspart “fiasp” versus insulin aspart Novalog, she said, " FIASP". I called Novo Nordisk and posed the question. If an MD writes an rx for insulin aspart, how does the Pharmacy know that what they are providing is FIASP or Novolog. She was stymied and said, well the generic for novolog is Insuln aspart. I said, but your website is calling FIASP and insulin aspart injection. She said well both have insulin aspart. I said, but the FIASP is 2 times more rapid than the novalog, so how does a novalog user, not a fiasp user know that the “insulin aspart” on the Wellcare formulary is consistent with FiASP and not novalog and she COULD NOT ANSWER THE QUESTION and it was esclaated. So, this is my question. When you got the generic insulin aspart , was a vial and did it say novalog on it? Wellcare told me that their “insulin aspart” was FIASP NOT novalog.
The simple answer is that they’re not selling generic FIASP, so it’s not an option at the pharmacy.
FIASP is just Novolog (insulin aspart) with niacinamide (vitamin B3) added to it. Niacin is a vasodilator, so it helps the insulin get into your blood stream faster. It’s a secondary ingredient, though, so both formulations have the same drug name.
There was pressure to sell affordable insulin, so they bottled their own Novolog with generic labels that just say insulin aspart, even though it’s the same exact insulin as Novolog, made by the same exact people, in the same exact factories, with the same exact ingredients. But FIASP is still their premium product, so no generic version has been made available for it. If you want FIASP, you and/or insurance have to pay the name brand price.
You can always verify yourself by reading the ingredients list on the vial. If it says niacinamide, then it’s FIASP. If not, it’s Novolog.
I imagine if they ever do release a generic version of FIASP, they’ll call it something different than insulin aspart, to avoid confusion.
I have not been able to find Novolog or Fiasp (or Afrezza) on any 2025 Part D formulary shown on Medicare’s plan finder at Find a Medicare plan
I have Cigna Part D…in summer 2024 my pharmacy submitted a prior authorization for Affrezza, because it was not on the formulary. It was approved quickly and is good for 1 year. So I am guessing that Affrezza can be had with many Part D plans but needs a prior auth.
These Part D plans all seem to cover only 1 or 2 insulins unlike private insurance that has a complete formulary.
Why does a pump user get insulin for free with their Medicare supplement but someone who prefers the multiple daily injections have to pay $35 per month fod insulin using part D for medicare? This doesn’t seem fair.
I agree with you, this doesn’t seem fair. Like any bureaucracy that administers a huge system like Medicare, policies are not always consistent and aligned.
Medicare provides coverage for durable medical equipment (DME) like breathing oxygen hardware, CPAP machines and wheelchairs. Insulin pumps are covered by Medicare under its DME policy. Supplies used in conjunction with DME hardware are included in the overall coverage much the same as CPAP masks and tubing. Therefore insulin, infusion sets, and reservoirs used in an insulin pump are included as part of the DME.
Unfortunately, this provides a benefit to Medicare pump users that MDI users are not eligible for. I suppose some MDI users could opt to change over to pump therapy to take advantage of this.