I have new insurance and my MD ordered 9 vials of insulin for 3 months, but insurance wants to know how many units per day I use.
I average about 55-65 units a day per my pump reading, but I want to give the number of 75 units a day. How many vials would that be over 3 months. I am brain dead, ha. I need to call MD back. Is 75 units a day a good number to cover site changes, etc. ?
75u x 90 days is 6750u. Each vial has 1000u, so you need 7 vials for 90 days. That is my PWD math, perhaps others compute differently! If add in say, 10u, for each site change and if you change every 3 days, then you need 30 site changes x 10u=300u extra. Assuming you won't really average 75 per day for the entire 3 months, then 7 vials will cover it all. My two cents.
so md originally order 9 vials, so I will be getting less, should I lie more?
Yes.
Thanks to both of you, I lied and went with 85 units, I think I might be going to jail, wait until I order my test strips, but that will be a truthful number that they won't believe and/or cover.
I'm so tired of pharmacy benefits managers and their stubborn reliance on exact math. If you and your doctor want 9 vials for 90 days then just reverse engineer the math so the pharmacy can't do anything but comply.
Nine vials divided by 90 days = 9000 units/90days = 100 units per day. So your doctor should "order" you to take 100 units of insulin per day. That's what needs to be written down.
If I start to develop an "over-stock" of insulin because of this, I just don't order for one of the 90-day periods. You get all the insulin you need, the pharmacy has complied with your doctor's orders, and everyone is happy. And you save a little bit of money on 3 copays for one year instead of 4. I look at it as my compensation for dealing with the pharmacy benefits manager idiots. (Sorry, I've wasted more time on telephone hold with them, fixing their mistakes, trying to get the supplies I need.)
Having a little extra insulin is not a problem; coming up short is a problem, your problem. Our lives are hard enough managing our BGs all day, every day. They don't need to be made more difficult by some bean-counter!
Terry that is what my endo did and I did develop an over stock but now I have new insurance and I don't go to my endo anymore so my primary md called me, dang I almost said 100 but......ahhh well 85 will have to do I guess, but I so agree with all your statements, dang I should of waited a day to call back
You'll still have 1 vial or so to cover the insulin wasted in set changes, etc. I often change sets when I get under 20 units left, so there's another 20 units needed to cover each set change. It looks like you'll have enough and that's the most important thing.
yep I change with 20 left also, dang was not thinking, never had to think about it I guess, and I use to be good at math, ha
And heaven help us if we drop a bottle on a tile floor, as I once did.
My doctor does what Terry suggests - he just reverses the math.
Ruth
My pump team writes for about a third more than I use. It makes up for pump priming and also for changes in basal/bolus needs, dietary variations, exercise /activity variations as well as the seasonal changes in insulin requirements. Don't forget to include monthly hormone fluctuations as well.
It’s not lying, the current computerized system doesn’t know how to recognize dosing for variable day to day use and how to allow for the necessary uncounted insulin beyond your total daily dose that accounts for things like filling the tubing and cartridge, site failures, sick days, insulin that’s stuck in the cartridge and tubing but not counted coz it’s a buffer, etc.
Realistically the only way to handle this is to include the extra insulin into the total daily dose. It’s not anything you’ll get in trouble for.
Amen Terry!
Yeah, one time I got infected poison oak on my legs and had to double the dose of insulin for several days as the infection sent my insulin resistance through the roof.
???? Did insurance call for the unit question, or was it the pharmacy? My pharmacy requires the units per day to do their stupid vial count calculation. And ditto the whole gang here who recognize the extra units that pumping requires. Not to mention when a bottle goes bad for no known reason.
damn it was the mail order pharmacy not the insurance, double damn
Now I am really going to be locked up for some reason the mail order pharmacy called me today to say they could not fill a monthly RX for another drug, MD needs to write for 3 months. I called my MD and they said they cannot write this type of RX for 3 months so now I am going with Target pharmacy for that order. Then I asked if they had faxed the 85 units to the mail order pharmacy as yet and they said no, so I asked them to change it to 100 units, omg, this is way too much work, and why did MD not tell me they would not fill my 1 month RX and why had they not faxed the insulin RX as yet, ahhhh. Hope it all works out. :)
Karen - You're getting a sample of the nuisance I've felt over the years dealing with a mail order pharmacy benefits manager. It's why I called them idiots in a previous comment on this thread. I know that most of these people are just trying to do a job but they don't get how precious our diabetes supplies, especially insulin, are to our lives.
Glad you changed the units/day to 100. You'll have a comfortable supply to cover any of the many incidental things that can push up a units/day number. One time I discovered 6-8 vials of insulin frozen in my malfunctioning refrigerator. Stuff happens! I was lucky enough to receive a regularly scheduled 90-day shipment a few days after that.
Got my nine vials of insulin today for $80.00, diabetic win :)
now I am ordering pump supplies with my new insurance and did not realize how low in reservoirs I am. Just ordered via Medtronic, changed my insurance changed my MD to my primary so will need a new RX and used my old HSA credit card because I had funds. I am setting myself up for failure.