So, as many of you know, our son, Liam, is going to be put on the pump this coming Thursday. So, our doctor put in a prescription for syringes, test strips and vials of insulin to get us prepared for the transition. My wife goes to pick up the prescription and finds out that the cost is $268 for a 30 day supply of the Humolog insulin. …???
So, she asks if it would be cheaper if she purchased in 90 day supplies and the tech there said he didn’t have that information, that it would be something we’d have to investigate with our Insurance. So, she doesn’t fill the prescription; instead, decides to come home to call CVS Caremark (our prescription insurance company) and ask them about it.
Come to find out, FIRST, Humolog isn’t even “preferred” within our BCBC plan…but Novolog IS. SECOND, although the 30 day supply costs $268, if we fill a 90-day order, we would only pay $200!!! This is because there is a “cap” on the amount we pay for prescriptions >= 90 days.
So, this is where my confusion comes in and why I feel communication sucks…WHY would the medical Endo team not be able to communicate with our Insurance to find the PREFERRED medicines, to determine which plan (30, 60, 90 day, etc.,) would be CHEAPEST and THEN submit a prescription for our son based on that information? Why do we have to find out the hard way that the info sent over by the Doctor is the most COSTLY of all options??? They submitted a prescription for Humolog, 30 day supply (not-preferred, no cap associated), instead of a Novolog, 90 day supply (preferred AND has a cap of $200 associated with it.)
All this time it appears that we could have been paying LESS each prescription with our MDI had we known that Novolog was “preferred” and the Insulin we are currently using, Humolog, isn’t.
The lack of communication all around just makes me more frustrated than I can even begin to express.
It’s good that we found out this information now…from all that I’ve read on this forum and others, Novolog seems preferred over Humolog anyway…it still doesn’t make the Insurance to Doctor and Visa Versa communication issue any less frustrating.
– END OF VENT –