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Post by Deleted on Jan 5, 2015 21:06:23 GMT -5
So I guess I'm confused
Traderdennis tells us it's no approved, that his endo is on the panel and they voted down prescribing it, but Lynn shows a screen cap where it's obviously approved.
I asked for the endos name and haven't been given it. Forgive me if I'm just a wee bit suspect.
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Post by jpg on Jan 5, 2015 21:08:24 GMT -5
jpg, Did you click on the picture to enlarge it? Hmmm... That was embarrassingly easy. Thank you, JPG |
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Post by babaoriley on Jan 5, 2015 21:14:30 GMT -5
It was more than just a one line response. The doc talked about how adcom came up with their decision was flawed. Also how multiple cartridges for T2's would be very inconvenient, which I rebutted that in 2015 larger cartridges will be available. He went into how the docs colleagues were also against in at their department conference, which I really can't dispute. This of course is one small example in a very large pool of HMO's / PPO's. The doc talked about how adcom came to their decision was flawed? That's simply not very believable. |
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Post by BD on Jan 5, 2015 21:15:44 GMT -5
Forgive me if I'm just a wee bit suspect. I think you mean "suspicious"  |
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Post by babaoriley on Jan 5, 2015 21:16:17 GMT -5
Lynn, is that the paper you typed up this morning? Nice job! LOL!
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Post by Deleted on Jan 5, 2015 21:36:34 GMT -5
Forgive me if I'm just a wee bit suspect. I think you mean "suspicious" My phone has a mind of its own |
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Post by spiro on Jan 5, 2015 21:59:41 GMT -5
Why are we getting more information out of insurance companies than MNKD or SNY? I am not going to fall for it, I still hate insurance companies.
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Post by traderdennis on Jan 6, 2015 10:14:55 GMT -5
I think you mean "suspicious" My phone has a mind of its own No, I will not disclose my Doctor's names on a public forum. Click below to view KP's 31 page formulary PDF. No Afrezza. jmp.sh/qZTWLth |
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Post by traderdennis on Jan 6, 2015 10:25:12 GMT -5
Glad it is on Medicare Part D, but that still does not show in their formulary for Socal. jmp.sh/qZTWLth |
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Post by jpg on Jan 6, 2015 10:35:54 GMT -5
Glad it is on Medicare Part D, but that still does not show in their formulary for Socal. jmp.sh/qZTWLthHi TD, I agree publishing your MDs name would not be great for your relationship with him... I am by far an expert on this insurance thing and rely on more knowledgable board participants for their insights as to how these things work. From my perspective of what has been said in this tread and from past credibility of posters you seem to be skating on thin ice on this topic? Are you saying other posters are wrong or are you adding nuance? If you are adding some nuances could you spell them out for those like me who are less knowledgable about this coverage process. Thank you, JPG |
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Post by traderdennis on Jan 6, 2015 11:09:49 GMT -5
Glad it is on Medicare Part D, but that still does not show in their formulary for Socal. jmp.sh/qZTWLthHi TD, I agree publishing your MDs name would not be great for your relationship with him... I am by far an expert on this insurance thing and rely on more knowledgable board participants for their insights as to how these things work. From my perspective of what has been said in this tread and from past credibility of posters you seem to be skating on thin ice on this topic? Are you saying other posters are wrong or are you adding nuance? If you are adding some nuances could you spell them out for those like me who are less knowledgable about this coverage process. Thank you, JPG Hi JPG, Writing may not be my strong point. I am a member of KP Socal. For my insurance to cover a drug it must be on the list. I am under 65 and actively working so I am not sure how Medicare Part D works. If you look at Lynn's screen shot, it shows coverage via Medicare Part D on the formulary list. The KP members formulary that I uploaded shows drug coverage for all KP members. Co pays are determined by the actual insurance coverage agreement, eg Public Employee union members have very small co pays in So Cal, I typically pay actual price for generics up to a $20.00 copay per month for Test Strips that are not a generic item. So I can't speak to how Medicare Part D works with Kaiser. I am only an active participant in managing my own care and knowledgeable |
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Post by Deleted on Jan 6, 2015 12:25:54 GMT -5
Glad it is on Medicare Part D, but that still does not show in their formulary for Socal. jmp.sh/qZTWLthLooks like the link you posted is specifically for KP's California marketplace.... or does that apply to all of KP's Insurance plans and all of its subscribers? |
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Post by traderdennis on Jan 6, 2015 12:49:04 GMT -5
Glad it is on Medicare Part D, but that still does not show in their formulary for Socal. jmp.sh/qZTWLthLooks like the link you posted is specifically for KP's California marketplace.... or does that apply to all of KP's Insurance plans and all of its subscribers? I said above, formulary is the same for all members. Doctors and Staff do not know what specific plan their members are on. Co pays will vary greatly depending on the specific plan. |
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Post by mike0475 on Jan 6, 2015 14:56:35 GMT -5
Spiro, can you elaborate on your thought process regarding info from insurance versus MNKD/SNY?
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Post by savzak on Jan 6, 2015 15:42:05 GMT -5
Spiro, can you elaborate on your thought process regarding info from insurance versus MNKD/SNY? Mike, I'm pretty sure Spiro meant to ask why we "aren't" getting more information from the companies regarding the status of insurance coverage. |
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