Skip to main content

Appeals Letters... Fighting for Diabetes Meds I Need


I've wanted to share these two appeal letters that my doctor and I crafted in order to get the needed insulin.

Clearly, this is our decision. Non-medical switching isn't cool, and I don't want to be a part of it. When it comes to my medicine and health supplies, my doctor and I should be the ones deciding what's best for me --not an insurance company or Pharmacy Benefit Manager (PBM) and insurer that sets a formulary.

And so, once my insurance company offered an initial denial for each of these requests, we fought back. For the sake of #PrescriberPrevails -- because this is our choice to make, not anyone else to make. That is basically practicing medicine without a license, and that's illegal.

Here are my two appeal letters, one for Afrezza inhaled insulin and another for Tresiba basal insulin. Both succeeded in getting coverage from the said insurance company.

My Afrezza Appeal Letter

https://drive.google.com/file/d/0B05u4rlsHt-iTjhHTExIZTlmSTQ/view?usp=sharing


My Tresiba Appeal Letter

https://drive.google.com/file/d/0B05u4rlsHt-idE9iNkVmY2k4bHM/view?usp=sharing


Hope these are helpful, for whatever they're worth to people. It all comes down to #DiabetesAccessMatters, #PrescriberPrevails, and #KeepMyRx. My doctor and I should be making these decisions, not anyone else.

Comments

TheSavvyDiabetic said…
Thanks Mike ... these are GREAT letters and so wonderful that you're sharing them. GOOD LUCK! And I'm so sorry it all has to be this difficult!
September 1, 2017 at 4:04 PM
Unknown said…
Mike, I told that you are great. This type post is very rare and I found it from you. You talk about appeals letter that most needed for me. I also request to help and click to read about professional apology letter for our.
February 3, 2018 at 8:50 AM
Post a Comment

Popular posts from this blog

Welcome to the End of the World?

Well, did anyone think this is what 2020 would look like? Global pandemic and worldwide public health emergency, everything shutting down and a potential economic collapse on the horizon. Holy fuck. ' A "Pandemic (in Quarantine) Playlist on my Spotify is now a thing, and my own remote worklife now in its 8th year has taken on an eeerie new spin. As are my watchlists full of dystopian and post-apocalyptic TVs and movies for streaming in these strange times. All of my work travel and conferences for the spring have been nixed, and we're all watching closely to see what the impact may be for summer events. What about my "underlying health condition" that is type 1 diabetes? So far, so good. No signs of anything astray. As I've shared over on DiabetesMine, I have been using the Tandem t:slim X2 device since mid-October 2019. That followed three-and-a-half years of Multiple Daily Dosing with pens and Afrezza inhaled insulin insulin. I starte...
62 comments
Read more

A Writer's Pen

A writer carries a pen. That is the way it is. For as long as I recall, that's how it has been. Moments have appeared, of course, where that vow failed. Where I did not have a pen to write with. Where the pen was in my hand, but it didn't write. Moments in history are marked by the written word. Journalists know and live this truth*.... ( yes, truth matters. Facts matter. Alternate versions of both do not **.) ... [ the fact that we have to emphasize this in 2020-21 is ridiculous, but the reality exists ]. I carry a pen. Because I'm a writer. Because the written word matters. Because facts and details matter. Context is everything. Painting a picture with my words is what I've done, professionally and personally, for so long. Words have painted a picture, opened a portal into the heart and mind. I've read what others have written with their own pens, even if those pens aren't physical but mental and those words have materialized from digital tools. The idea of w...
33 comments
Read more

Flapping the Gums

No time for my chatty-typing fingers to engage you today. I'm off to the dentist's office for a dreaded appointment. Thanks to the wonders of D-enduced periodontal disease, this should be a visit full of poking, prodding, pain, and likely some bleeding. Great times. Not looking forward to this visit. Or the next more painful one. I see soup in my future. Maybe Easy Mac. But, I digress. That's all fodder for a future blog post. In the meantime today, talk amongst yourselves. Flap those online gums in the blogging world. And remember to brush and floss.
40 comments
Read more