Insulin cost
CAS317
Posts: 267 Member
I just started a new job in February so my insurance plan changed. With my old insurance I paid $80 for 5 bottles of Humalog...I only take about 30 units total daily. So 5 bottles will last awhile. Oh and btw my MD's medical assistant wrote the script to state that I should use 45-50 units daily (I don't know if she did that on purpose to save me some money or if it was an accident). So I go to fill my Humalog yesterday and I now have to pay $200 for 5 bottles...WTH? That's more than double. So I'm just wondering how much everybody else is paying out of pocket. I was thinking too...many insurance plans have free medication or for like $4 a month for type 2s. Now how does that work? We have Type 1 and didn't ask for it by becoming obese and not exercising. So why do all of the type 2's get rewarded with cheaper medication than us??? Ok rant is over,
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You're not the only one that feels that way about the cost of type 2 meds, trust me.
I'm not on humalong, I use Novolog.
But about a year ago I was without insurance and they wanted over $100 for one bottle.
I recently filled my prescription thru insurance and paid $150 for 9 bottles.0 -
Im from PEI, Canada and the provincial government covers a portion of the insulin here under the Diabetes Program. I end up paying only $19.95 for 5 bottles of Humalog or Humalin N. They do not cover Levemir which sucks (I had my best control on that insulin.) As for strips, the government will cover 100 strips per month and we pay $11 for it - strips over that amount we pay full price. We are lucky we have this plan here especially people for me who don't have health coverage. If I could change one thing about the program, it would be to cover 200 strips a month instead of 100. 100 strips is really stretching it to get through testing for the whole 30 days.
As for your paying $200, your new health coverage must really suck! If you have a hubby, then maybe his insurance will be better for you to use??0 -
I have been on a high deductible insurance for over a year now and all of the costs come out of my pocket until the deductible is met. The first few months, more like 4 or 5 months, of the year I am spending $436 a month for 3 vials of Humalog. I don't use all 3 vials and it can actually last closer to 2 months, but that is how my doctor writes it incase I go carb crazy. I just started a new job with a regular PPO and I can't wait for the new rx copays to go into effect - $436 a month is just ridiculous!0
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I have a high deductible plan and diabetes (especially pump) supplies work through the deductible pretty fast. Also, my employer contributes to a Health Savings Account that I can use to help play a portion of that deductible. I was done for this year in March. The remainder of the year will be relatively low cost, like a PPO, but with low monthly costs. I figured the high deductible plan it good for people who have little need (my perfectly healthy 20 something son) or someone with high need (50+ diabetic me). YMMV.
I usually use 6-8 test strips/day. I can imagine being limited to just 100 for the month. My experience with various plans over the years is that the insurance companies know that frequent testing means better health so, if you ask your doc to write the prescription with daily usage, the insurance comes through. They don't want you to get a bunch of strips and not use them or give them away.
This disease if expensive and complicated. There's no doubt.
-Bob0 -
Bob-I thought about the high deductible plan, but not for very long, and decided against it. My employer also offers a HSA. I'm not very good with uderstanding everything about insurance plans. I probably chose the wrong one to get the most bang for my buck. I was kind of limited though. I live and work in Indianapolis. I work in Methodist (where Kevin Ware had surgery on Sunday!!!!). So all of their insurance options are geared towards rewarding those who use MD's within the network. My MD's are all in another hospital which is the same hospital system I worked in for the last several years. I've been with many of them for a very long time so I didnt want to sacrifice the relationship I have already established. There are so many things to take into consideration when choosing an insurance plan. I'm going to weigh the pros and cons and maybe consider something else during my next open enrollment. Maybe this one isn't so bad??? I was paying about $250 every 2 weeks for my premium for me and my so. It's gone down to $185 now but I'm paying my saving back in my insulin cost!!! We Type 1's will never win in the insurance game:( oh and btw does anybody have to use Edgepark for your pump or cgm supplies? I just had to switch to them and my experience thusfar has been unacceptable:(0
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I started a new job last year - I now pay $35 copay per bottle of Levemir - I need more than one bottle/month so instead of letting me have two, I just get to refill my prescription earlier and pay the copay again. I recently switched to Apidra and there hasn't been any copay (I get and only need one bottle/month).
For test strips, it's under a different umbrella and I have to pay 20% retail from an online pharmacy (I use Diabetic Care Services and I've been happy with them) - I got a three month supply for about $110 but I'm hoping it lasts me a little more than three months.
At my old job it was the same except they subsidized half of my insulin copays and I was allowed to get as many strips as I needed for the $35 copay/month..0 -
I have a HDHP too. It's excellent. We blow through the first 4,000 in a month or two, tax-free from the HSA, and then we pay nothing for the rest of the year. No more financial "death from a thousand copays".0
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The issue I've run into is that insulin is not like a pill, you can not get an even 30 day supply. So, if it takes a vial and a half to get through a month, I have to wait until the first vial runs out and then get the second vial and pay twice.... So even though a one month supply is supposed to be $30, I end up paying $60 because I don't need two full vials to cover the month but one isn't enough. I asked the insurance company if I'm just supposed to go without insulin for the remainder of the month after one vial runs out and how much that would end up costing them and me and they didn't answer. It's really ridiculous.0
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The issue I've run into is that insulin is not like a pill, you can not get an even 30 day supply. So, if it takes a vial and a half to get through a month, I have to wait until the first vial runs out and then get the second vial and pay twice.... So even though a one month supply is supposed to be $30, I end up paying $60 because I don't need two full vials to cover the month but one isn't enough. I asked the insurance company if I'm just supposed to go without insulin for the remainder of the month after one vial runs out and how much that would end up costing them and me and they didn't answer. It's really ridiculous.
Exactly - I'm going to call mine just for fun and see what reason they give me for not allowing me to have a month's supply..0 -
On second thought, since I probably already know their answer (10 mL bottle is just too much "extra"), I think I'll ask for a change in prescription to the pens - 3mL so I *should* be able to get closer to what I need (maybe I'll call and confirm *that*).
They're easy to carry around and about as easy to pull insulin from as a regular bottle..0 -
I believe the Affordable Care Act finally orders the FDA to finally create standards for manufacturers to start making generic biologics (like insulin). Patents for Lantus and Humalog have already expired, so the hope is that generic forms would lower prices substantially, just like they have for many other drugs.
http://www.fda.gov/Drugs/DevelopmentApprovalProcess/HowDrugsareDevelopedandApproved/ApprovalApplications/TherapeuticBiologicApplications/Biosimilars/
It'd be great when a day comes that I don't have to be a slave to a job I dislike just to have insurance to enable me to pay for my diabetes supplies....obviously, that day's not close enough for many on this forum, but affordable 2nd generation biologic insulin may be in all of our futures.0 -
^I really hope some pharma jumps on that soon!
This is a pretty handy tool to keep tabs on dates, too (though some of the abbreviations/terminology/listings I don't quite get for some drugs):
http://www.accessdata.fda.gov/scripts/cder/ob/docs/querytn.cfm0 -
Hi Cas,
So much in your message. I hope you folks are able to take care of Kevin Ware. That's an amazing story.
I also don't know how to pick insurance. It seems every years is a gamble and since every person's situation is different and changes every year (changing medical needs, kids growing up, etc) I have no clue how pick the best plan. I always have a bit of buyer's remorse no matter which plan I pick.
I agree with you regarding staying with a long time health provider. Part of my reason for picking the high deductible plan was so I could choose any doctor I wanted and not be limited or penalized for going "out of plan". With my plan, it's still there somewhat but not to the extent as I have experienced in the past.
My plan through Aetna includes a mail-order pharmacy. I am able to get a 3-month supply of insulin and test strips all at once. It's expensive at the start of the year but because my employer contributed to a Health Savings Account it helps takes out the sting a bit. The problem is the HSA is funding throughout the year while the high deductible is due at the start of the year. The first year this was a painful surprise. I've had the plan now for 3 years and there's always some remaining balance to help.
-Bob0 -
@ Cas - - My insurance made me switch over to Edgepark last year for my omnipods and other supplies and I haven't been too happy with them either. I was buying straight from omnipod and now it just seems like an extra hoop to jump through.
Also, at the beginning of this year "renegotiated" their contract with my insurance and I now pay double for my pods then what I was paying. Not sure if it was Edgepark or my insurance that initiated the change but still not cool.
Luckily, my insurance's mail-order pharmacy hasn't change and I still pay the same amount for a three month supply of insulin. Kinda sucks I can't just go and get a vial from a local pharmacy though, I've miscalculated a few times on how long my vials would last and cut it too close for comfort once or twice.0 -
I Pay 50 for 9 I had my doc write a script that said specifically that because if not they were gonna give me 3 bottles0
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We pay $75 for a 3-month prescription of Humalog- which actually lasts a good while longer since our Endo wrote it for 9 bottles every 90 days.0
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I pay $10 per bottle. When I fill my RX I get 3 bottles at a time, so I pay $30. I use NovoLog0
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Oh and by the way........yes, Edgepark sucks. They didn't use to have any issues, but in the past year their customer service has turned to hell and their entire company makes mistake after mistake and refuses to accept responsibility. They are slow and lazy and I HATE that I have to use them for my pump supplies.0
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I'm on my mom's insurance plan till I turn 26. She has good insurance. I get roughly 9 bottles of Humalog for $90. That lasts me at least three months. I'm in school to be a pharmacy technician and thousands upon thousands are spent on diabetic supplies. (exact numbers escape me right now)0
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Hey,
Im new here (first post actually) but I felt compelled to share.
I was diagnosed at age 19 (2005) and at the time I had poor insurance. It got worse, I ended up being dropped from the policy for leaving the college I was in and therefore I lost my lifeline.
I randomly found an answer to this problem.
Walmart.
Walmart has a "deal" with lilly (makers of humalog) and they offer their insulin (rebadged) for $24.96 a vial. (thats the cost with no insurance)
It gets better.
They also have a tester for $9.96 and 50 test strips for $9.00 even.
If your insurance is charging almost double this it would be worth your while to see if it would be cheaper through your insurance to buy this or even just buy it outright and skip the insurance.
I hope this helps.
God Bless
-Stephen0 -
have you considered changing insulin to Apidra? I believe they have a program that can save you some or all of your copayment.
I pay nothing for Apridra & $25 for 5 Lantus Pens.
Lise*0
