|
|
Post by pmikeks on Sept 3, 2015 15:36:43 GMT -5
Blue Cross of Tennessee "S" started covering affrezza September first. My out of pocket cost for future prescriptions wil be about $35 according to my pharmacist who I've gotten excited about affrezza. Coverage doesn't require prequalifiing or any of that BS. Hopefully many other insurance companies will follow suit. I check formularylookup.com fairly often. Have you tried finding your plan on there to see if it is accurately reflected? It would be interesting to use this as a test case to see how long it takes for it to be reflected correctly on that site. If you don't want to check yourself, can you provide the complete name of the drug plan you fall under? What is "S"? Sorry if that is obvious to most. Blue Cross has about 30 different plans designated by a numbers and a letter (S and E) are the ones I'm most familiar with. I'm on my wife's group plan designated"blue network S RX03. No I haven't looked it up, I went in to pick up a different med and managing pharmacist came over and told me the Sanofi Rep was there couple days earlier and told him Affrezza and Toujeo were both now covered starting September 1st Pharmacist went over to their computer and brought me up and said sure enough it was now covered. If it helps September is the start of a new year when we get to start paying our deductibles again at BCBS. |
|
|
|
Post by dreamboatcruise on Sept 3, 2015 18:06:25 GMT -5
On formularylookup.com I see only 13 plans listed for BCBS Tennessee. Of those 8 are list as no coverage, 4 are listed with non restricted coverage Tier 3 and 1 is listed with preferred Tier 2 coverage. I'm guessing you're Tier 2 given $35 copay. That one currently listed as preferred is...
BCBS of Tennessee Two Tier PPO
I didn't see any of them listed that seem to have a name similar to what you state, so they most be slicing and dicing in some different way than what patients see.
Will keep an eye out on that to see if those states change for BCBS TN.
|
|
|
|
Post by cyn on Sept 4, 2015 10:42:46 GMT -5
FYI, I just checked Afrezza coverage under the military TRICARE insurance benefits available to active and retired personnel, including dependents. The pharmacy benefits are contracted with Express Scripts, Federal Pharmacy Services. As of 9/4/15, the out of pocket cost schedule is as follows;
Mail Order: Up to 90 day supply can be filled (multiply by 3 co-pays).
30 day supply for 4 Unit(30) Cartridge, with inhalation device: Active duty $0.00 Non-active duty $16.00
Retail Network Pharmacy: Up to 90 days can be filled (multiply by 3 co-pays)
30 day supply for 4 Unit(30) Cartridge, with inhalation device: Active duty $0.00 Non-active duty $20.00
Note: All other dosage cartridge strengths (i.e. 8 Unit, 12 Unit) are not yet available thru Tricare mail order and must be acquired via retail pharmacy network. Retail pricing for these cartridges are not viewable thru the Tricare Express Scripts website.
|
|
|
|
Post by xoxoxoxo on Sept 4, 2015 11:16:40 GMT -5
Let's count the number of Active Duty military with diabetes..... 0
That's big though for dependents and retired military eligible for Tricare
|
|
|
|
Post by dreamboatcruise on Sept 4, 2015 12:43:04 GMT -5
Let's count the number of Active Duty military with diabetes..... 0 That's big though for dependents and retired military eligible for Tricare Seems like there are likely T1 as well as T2 active duty. One may become ineligible for combat positions if on insulin, but there are many non combat positions in are armed services. Not everyone in the military is a ripped 20 year old Marine. |
|
|
|
Post by mannmade on Sept 4, 2015 12:45:36 GMT -5
And active members have dependent a who might be diabetic. And let's not forget all the cilvilians who work for our armed forces and their defendants.
|
|
|
|
Post by pmikeks on Sept 4, 2015 12:47:44 GMT -5
On formularylookup.com I see only 13 plans listed for BCBS Tennessee. Of those 8 are list as no coverage, 4 are listed with non restricted coverage Tier 3 and 1 is listed with preferred Tier 2 coverage. I'm guessing you're Tier 2 given $35 copay. That one currently listed as preferred is... BCBS of Tennessee Two Tier PPO I didn't see any of them listed that seem to have a name similar to what you state, so they most be slicing and dicing in some different way than what patients see. Will keep an eye out on that to see if those states change for BCBS TN. Probably because the plan I'm on is a Group Plan and could be a hybrid that may or may not be listed. The number I threw out is what a broker who represented BCBS, Cigna and couple others told me when I was comparing prices to the group plan. Wife isn't mad at me anymore so I'm staying on the group plan. Haha |
|
|
|
Post by xoxoxoxo on Sept 4, 2015 15:38:41 GMT -5
Let's count the number of Active Duty military with diabetes..... 0 That's big though for dependents and retired military eligible for Tricare Seems like there are likely T1 as well as T2 active duty. One may become ineligible for combat positions if on insulin, but there are many non combat positions in are armed services. Not everyone in the military is a ripped 20 year old Marine. Sorry, that's not the case. I'm an officer in the US Air Force and we're not bound by the same discrimination policies in federal law that protects PWD. Diabetics are ineligible to enlist/join. If you come down with T1/LADA/T2 while on active duty a medical evaluation board will be convened which almost always will lead to a medical separation or retirement. The only people who are kept in have to show they can keep their HbA1c below 7% and then are restricted from deployments or going to areas where they can't keep their insulin stored at the proper temperature. There's an army manual that covers this somewhere. These days with the army drawing down it's pretty much a no go for people with deployment limitations, but there are exceptions. I will say that there are probably more in the military who treat themselves without telling the military about their diabetes. Particularly folks close to retirement that don't want to get kicked out. The VA on the other hand handles many many many thousands of diabetics who are entitled to medical care based on their military service. |
|
|
|
Post by rozale on Sept 4, 2015 16:29:14 GMT -5
And active members have dependent a who might be diabetic. And let's not forget all the cilvilians who work for our armed forces and their defendants. Civilians who work for the DoD aren't covered by tricare, unless they are vets. Civilians who work for the DoD are covered by private insurance plans such as BCBS, Aetna , etc. |
|
|
|
Post by mannmade on Sept 4, 2015 19:02:23 GMT -5
My bad.... Ty
|
|
