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From Pierre, South Dakota, USA:

My 12 year old daughter was diagnosed with Type 1 diabetes approximately 16 months ago. Recently my health insurance company with no notice at all took the Lilly insulin, which my daughter currently takes, off of their preferred formulary list and wants my daughter to switch to Novolin insulin. I am concerned about switching my daughter over to the Novolin and disrupting her blood glucose numbers. She currently is in excellent control. She takes R, N and Humalog and am also concerned about mixing two brands of insulin, since Novolin does not make Humalog. What should I do?

I have written the insurance company asking for an exception since my daughter is on Humalog but, they seemed to just "brush me off" with their response. Do I have any other recourse?


Switching from Eli Lilly's Humulin NPH and Regular to Novo Nordisk's Novolin NPH and Regular should have little effect on current control although you may need to make slight adjustments in the dose. My question is, are you mixing N, R, and H, and if so, why? If this is what your physician is prescribing, you have 2 alternatives: 1) try NPH and Regular alone and see if control remains the same or 2) have your physician write a letter of medical necessity to your insurance company.


Additional comments from Dr. Quick:

Of course, you could always buy the Humalog insulin with your own money, but if you do, be sure to save the receipts so you can argue with the insurance company later about getting reimbursement.

It would seem that the first person you spoke with at the insurance company simply doesn't understand diabetes. Once you and your daughter's physician get the ear of the right person, there shouldn't be any problem with getting an exception. The problem, of course, is that it takes persistence to find the right person to talk with. You may have to talk to the benefits manager at the employer who's paying for the insurance plan, or write your state's Insurance Commissioner. If you do, send copies of all your previous correspondence, and send a copy to your Congressperson. The main advice I have is, don't give up! Otherwise, the insurance company wins, and your daughter loses.


Original posting 18 Jul 1998
Posted to Insulin and Social Issues: Insurance/Costs


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Last Updated: Tuesday April 06, 2010 15:08:58
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