Mail Order Medication Exceptions: Did you know?
Thursday, June 6, 2013 at 9:47AM
Scott Benner in Daddy's Blog, Insurance, Prescription, type I

 

Well I guess that you do learn something new everyday...

We are leaving for a family vacation next week so I went online and ordered a few diabetes supplies that we need for the trip. We use a mail order pharmacy and when I placed the order on their site, I was told that our insurance wouldn't allow Arden's Apidra prescription to be refilled until the 9th of June. This normally wouldn't be an issue but since we are leaving only a few days later, the insulin wouldn't arrive in time. 

So I called the 800 number and do you know what I found out?

There are exceptions that our plan allows for. I never knew before but I do now and I hope that you find out that your plans have similar fail safes built in. The best part of the exceptions? They trump insurance rules and restrictions! When the CSR tells the system to enact a restriction the order sails through the system and nothing can hold it up. Sweet!

I was told that there are three types of exceptions and that they each can be used three times a year if necessary, they are:

Emergency Exception: In case of an emergency, any emergency, I can call and have supplies sent that we require. 

Therapeutic Exception: Let's say that Arden suddenly begins to require far more insulin than she has in the past. Until I can get to her Endo and have the prescription rewritten, I just use the therapeutic exception.

Vacation Exception: Going away? Need extra stuff? Not time to refill yet? No worries... "Hello, I'm going on vacation, please send some more Apidra".

 

I hope that this information finds you well and is helpful the next time you run into a supply issue.

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