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
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