Wondering if anyone has had to navigate this and can direct me. I have BCBS-IL PPO. This was never a problem before but is now. I am trying to get my Glucagon prescription covered. It keeps getting denied at the pharmacy and BCBS says it is covered under medical. BCBS sends me to their preferred medical supplier (Allied) who tries to fill it under medical and BCBS denies it. We have been in this loop for nearly 2 months now. It is a loophole we cannot figure out and BCBS just keeps giving us the same run around. Thanks so much.
Hi @SandraLB. I’ve tried to intercede on my own behalf with suppliers with little or no luck. I’ve found that having my insurance and the supplier talk direction usually works. On one occasion I took down what I considered were extremely detailed instructions from a rep on what I needed to tell the other side. It started off well enough - until they asked a question or made a statement that sounded Greek to me. At that point I conferenced my insurance in on the call and let them hash it out, with success.
Thank you for the reply and suggestion. Both my husband and myself - on separate phone calls - spoke with both insurance and Allied at the same time and still to no avail. I will try, try again!
Persist my friend! On occasions I’ve had my doctor’s office contact them - perhaps that would help.
BTW, you know your needs, but I’ve had diabetes fire over 50 years and have only needed assistance recovering from a low a few times - on most occasions I woke to find my mom getting OJ down my throat (thankfully I was and to swallow), and I’ve only gone to the ER once from losing consciousness, and they have me Glucagon en route. That was probably 20 years ago.
Far be it for me to tell you whether or not to use it, but personally I don’t find it necessary. I do have an RX at my pharmacy and was on autofilll so I picked it up when it was time; but it’s always gone to waste from non use and when the RX ran out I didn’t fill it again.
Something to think about: if you use a CGM; or if you don’t use one AND you recognize the signs indicating you’re going low and can handle it on your own - perhaps you could do without one. That’s a big “if” - I’m just throwing it out there. If you’re new and adjusting by all means get it. Recently I started seeing ads on TV for an inhalable(!!!) treatment. Much more portable and easy to manage, although since it is so new I know nothing about insurance coverage. https://diatribe.org/fda-approves-nasal-glucagon-baqsimi-radical-improvement-severe-hypoglycemia