Thursday, August 31, 2017

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. It comes down to my doctor and I deciding what's best, 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 and #PrescriberPrevails. My doctor and I should be making these decisions, not anyone else.

2 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!

JOHNSON KATE said...

ALL THANKS TO DR WILLIAMS FOR THE GREAT DEED HE HAVE DONE FOR MY DAUGHTER?
My daughter suffered from diabetes type 2 for more than 20 years which we started experiencing in her when she turned 17 year and 5 months we all thought it will end but got even worse as days went by. We tried all several treatments and therapy prescribed by various doctors we met but to no avail, she lost weight even when she is eating and feel hungry,and She usually had Headaches. This were steady illness that disrupted her entire life, even at night she slept less because of this.It was during a casual conversation with a friend that i learned about Dr Williams herbal medicine I was able to contact him on his email address. and give him all the necessary information that he needed,few day later he sent me the herbal portion and his medicine was able to restore her back to normal and she is very okay now without any side effects whatsoever. If you have diabetes, do not hesitate to contact him on drwilliams098675@gmail.com for advice and for his product. I hope this also helps someone out there