When I was diagnosed with Type 1 at the age of five, I was blissfully unaware of the complicated relationship I would have with insurance providers for the rest of my life. It’s been 25 years now, and the experience has left me shell-shocked more than once.
The summer before college, my dad, who also has Type 1, started handing over the job of organizing medical responsibilities to me, including ordering prescriptions, asking my endo’s office to fax updated orders, and reordering supplies. I felt overwhelmed at first, but after successfully getting the supplies I needed when I needed them, I figured I was on top of things.
The first sign of trouble came when my insurance company denied me my Novolog insulin, saying they’d decided to only cover Humalog. Then I was denied coverage for my symlin and was forced to fork over $3,600 to a pharmacy clerk for my 3-month supply. I don’t remember what their excuse was, or why I hadn’t been notified that their formulary coverage policy had changed, but I remember crying in my car in the pharmacy parking lot for a very long time.
Things went downhill from there. My insurance company harassed me about why I need to test 10 to 12 times a day. They denied me pen caps for my symlin pen because they couldn’t grasp the difference between pen needles and syringe needles. They also blocked medical expenses for a car accident and for a hormone to treat cysts.
The most shocking moment came recently when I went to refill my basal insulin prescription. Did you know that a single bottle of Lantus could last for 90 days? Well, that’s what my insurance company thought anyways.
When I went to pick up my usual 90-day supply of Lantus, the pharmacy manager said my insurance company instructed her to only give me one bottle of the stuff. Their logic: the daily amount I took multiplied by 90 days totaled exactly how much was in one full bottle. I laughed and told the manager that was ridiculous; everybody knows that insulin has a 30-day shelf life, sometimes shorter if exposed to heat. But I soon realized I was wrong; my insurance company most certainly didn’t know that.
It was chilling to know that the people in charge of approving the medications that keep me alive don’t have even a basic understanding of my disease. It is up to those affected by Type 1 to push back to get such terrible policies changed. I encourage you to complain early and often when you confront such idiocy.
This article was originally published with the title “Low Points with My Insurance.”
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