With over 8 million people out of the 37 million diabetics in the US on insulin, there are a lot of people that will be surprised by their prescribing doctor early this year about their soon-to-change medication list. Novo Nordisk recently announced that they will be discontinuing their long-acting insulin Levemir. Our agency has already begun to receive phone calls from clients regarding this topic.

While we want folks to be aware of their alternatives for this insulin, I want this post to primarily be a message of empowerment for folks to know what to do in future instances of drug changes, insulin or not. First though, let’s talk about Levemir.

The CDC explains that there are seven types of insulin overall. To keep it simple though, there are three main “groups” of insulin: rapid-acting, intermediate-acting, and long-acting. Levemir is a long-acting insulin. Here’s the major factor on the healthcare side that can give some leeway for Part D: All Medicare plans with drug coverage generally must cover at least two drugs per drug category. Therefore, Levemir already has a long-acting insulin alternative for individuals that are taking it even before its discontinuation no matter what health insurance carrier they have for their Part D coverage, and most companies cover far more than just 2 options in their formularies for drug coverage.

Our job as an agency is to show our clients every option available for their needs. That’s our client-first mentality. Let’s consider an example: say a doctor tells a patient that Levemir is no longer offered and their doctor then recommends an alternative insulin, but that second option is not currently in their current insurance’s formulary. You’d be surprised how many people assume that they just simply have to pay for the entire insulin out-of-pocket or rely on a savings/discount card, like GoodRx. But here are just a few options that might just save them some financial headache.

Formulary Exception Ruling

Exception requests are granted when a plan sponsor determines that a requested drug is medically necessary for an enrollee. Therefore, an enrollee’s prescriber must submit a supporting statement to the plan sponsor supporting the request. If that exception gets approved though, the member is allowed to continue receiving that medication under their current insurance. Now while that exception may not apply to Levemir since it’s completely being discontinued, this has played a major role in assisting folks with medications that have had coverage issues in the past.

Different Carriers, Different Formularies

While I believe that all men are created equal, I certainly know that not all health insurance carrier formularies are created equal. It may seem obvious to say this, but it’s important to remember that not all companies are required to cover all the drugs out there. ABC insurance company might not cover the same long-acting insulins as XYZ insurance company. So if someone currently has ABC insurance company as their current coverage and their doctor recommends an insulin that’s not covered by ABC company but IS covered by XYZ company, then perhaps XYZ company might be a better fit for them.

More Options than Insurance?!

Our job as an agency is to help people. I know, a real shocker of a statement. In order to help people though, we as an agency don’t just look at insurance products. Insurance is just a tool. Our job is to use every tool at our disposal to assist our clients. We work with many federal, state, and independent programs that a lot of times have nothing to do with insurance. Perhaps there’s a company that works directly with manufacturers of generic prescriptions and sells them to consumers at cost with a slight markup that would be cheaper than the standard insurance routes. Why wouldn’t that be another tool that we want to help educate our clients on?

At the end of the day, our job is to be as great a resource as possible. We go beyond traditional education in this part of life by not only imparting knowledge but also instilling a sense of empowerment. We strive to equip folks with the skills, confidence, and mindset needed to take control of their own success in their health, life, and long-term care needs. Don’t feel stuck or tied to what one company or one insurance resource might give you. This is the land where you have freedom of choice, let us show you all your choices.