No More Januvia, Hello ? (Options When Insurance Won't Pay)

No More Januvia, Hello ?

(Options When Insurance Won't Pay)

Januvia Bottle With My Notes

Januvia Costs About $500 a Month

Insurance won't cover.
Insurance won't pay a penny.
Not even after I pay a $7500 deductible.
I won't even go into how much a pay for this crappy health care policy
Since that isn't today's point.

SO
Here I am emailing my doctor with options.
Metformin works somewhat but the high highs and low lows are a killer.
So I get his opinions on different meds
Oh and I Google.
A lot of Google searches.
Insurance will cover the old stuff
LIKE

Sulphonylureas

These drugs stimulate the insulin produced by the pancreas.
These can cause low blood sugars
YIKES!
I have read that stimulating the pancreas to produce more insulin
can be a bad thing if you're a Type 1.5
since it burns out the pancreas faster.
Which means more insulin later.
Right now though my concern is the lows.
I get low, really low, at night.
50s and 60s low.
Another negative,
My Dr. says no.

Thiazolidinedione or Glitazones

This drug reduces the  resistance to insulin.
Well, that isn't helpful!
Seems the antibodies test I had shows that I am NOT insulin resistant.
Ok, so let's not take a drug just for fun.
If I don't need it, I don't want it.
Thank you, NO THANK YOU!!!

 

 Gliptins or DPP-4 Inhibitors

Januvia is in this class.
And it helped with the high spikes and low drops.
I called insurance and asked for help with the website for pharmacy benefits.
NOTHING is covered until I meet the deductible??
NOOOOO she says.  Let me check she says.
We review what her computer says my benefits are.
Januvia is not covered, not at all.
BUT
ALOGLIPTIN IS!!
It is in the same family as Januvia
Woohoo!!
My doctor actually suggested it
AND - SAY WHAT??!!
Insurance will cover it with a co-pay of $15!!!

UHHHH, NO....
The prescription is sent over.
The pharmacy wants to fill it.
The insurance says nope,
Not going to approve,
Not until the doctor fills out said forms,
Not until they think I need it.

 

Waiting

So now I wait.
I wait for insurance to say yes or no.
I wait for insurance to decide what they think is best for me.
I pay for insurance to help me stay well
And for what I pay
I should get the gold standard treatment.

BUT
We will see.
I wait.


Have a great numbers day!

Jan