Finding a PCP

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Diabetes Medication and Supplies Discuss diabetes medication and diabetes supplies here. Talk about experiences you have with certain medication and diabetes supplies, or with certain diabetes supply stores or manufacturers.


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  • 2 Post By itissteve
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Finding a PCP


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Old 10-23-2019, 15:26   #1
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Default Finding a PCP

I've been using Tresiba since June. I have to pay $200 every time I see the NP endocrinologist. The bill is $500 and my insurance pays $300.

I'm trying to find a PCP who will prescribe Tresiba or any diabetes meds that I need but none so far will touch my diabetes.
Does everyone who takes insulin have to go to an endo? I really can't afford to continue this way.

I'm 64, semi-retired and am on Obamacare.
How do I find a PCP who will address all of my medications? With my insurance I have to stay with Saint Lukes.
Thank you and I hope you're all having a good day.

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Old 10-23-2019, 15:44   #2
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Every medical plan is different, but if your diabetes treatment with the Tresiba is stable, why can't that endocrinologist refer you back to your PCP? Certainly a PCP (M.D., D.O.) could write an Rx for Tresiba. I suppose that could be a question for your current PCP (if you have one).

If you don't, I would call either customer service or the Patient Ombudsman at your provider and explain the situation: that visiting the endo instead of a PCP each time causes financial hardship and that you would like their help in finding a PCP within their system who would work with your endo in managing your treatment.

It's in their interest to do so. The endo doesn't see anything but your diabetes (just as a cardiac surgeon doesn't see your trick knee). A doctor (or physician's assistant or nurse practitioner) should be helping you manage your overall care.

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Old 10-23-2019, 15:47   #3
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Quote:
Originally Posted by itissteve View Post
Every medical plan is different, but if your diabetes treatment with the Tresiba is stable, why can't that endocrinologist refer you back to your PCP? Certainly a PCP (M.D., D.O.) could write an Rx for Tresiba. I suppose that could be a question for your current PCP (if you have one).

If you don't, I would call either customer service or the Patient Ombudsman at your provider and explain the situation: that visiting the endo instead of a PCP each time causes financial hardship and that you would like their help in finding a PCP within their system who would work with your endo in managing your treatment.

It's in their interest to do so. The endo doesn't see anything but your diabetes (just as a cardiac surgeon doesn't see your trick knee). A doctor (or physician's assistant or nurse practitioner) should be helping you manage your overall care.
I'm calling my health insurance now. Thank you.

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Old 10-23-2019, 19:52   #4
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Quote:
Originally Posted by Nemo View Post
I've been using Tresiba since June. I have to pay $200 every time I see the NP endocrinologist. The bill is $500 and my insurance pays $300.

I'm trying to find a PCP who will prescribe Tresiba or any diabetes meds that I need but none so far will touch my diabetes.
Does everyone who takes insulin have to go to an endo? I really can't afford to continue this way.

I'm 64, semi-retired and am on Obamacare.
How do I find a PCP who will address all of my medications? With my insurance I have to stay with Saint Lukes.
Thank you and I hope you're all having a good day.
Is there a local chapter of the ADA in your area? (American Diabetes Association) or something called like that? They may be able to assist you. Because the cost of living with diabetes can be very expensive and there is no universal health plan for American Diabetics the ADA might be able to make some good suggestions on how to cut medical costs. Hope you work it out!

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Old 10-23-2019, 22:58   #5
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Hey Nemo - good to see you! Remembered you immediately from your ruby slippers!

Hoping you can find a PCP right away to help, but if you can't, any way to discuss the issue with your endo? Might s/he be willing to send a script for longer? My endo sent my insulin script with 11 refills, each script lasts 2 months and maybe there is a year's expiration, but if I stopped going to that endo I could still get my insulin at least.

Do you have good coverage for your insulin? I went into the donut hole (Medicare) and found a couple of very reputable Canadian pharmacies that are options, i.e. costs less than the 25% copay from Medicare.

Diabetes should not be such a significant budget line item! Very sorry you're having to deal with this.

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Old 10-23-2019, 23:49   #6
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Moon, thank you for the welcome!
I don't have any problems paying for my diabetes medications right now.
With my Obamacare insurance:
Tresiba is $5 per month because of a coupon the manufacturer gives on their website. They say it's good for a year.
Trulicity is $25 per month with the manufacturer's coupon. Good for one year.
Jardiance is $0 per month with the manufacturer's coupon.
Metformin is is like $2 for 90 day supply at Walmart.
It's just finding a PCP that will prescribe diabetes medications that doesn't charge an arm and a leg on each visit.
I have an appointment tomorrow with the endocrinologist.
But I doubt she will agree to a one year prescription because I need to lose weight so I can cut back or get off of insulin so she'll probably want to see me every 3-6 months.

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