GREENSBORO, NC:: Katie Young has a routine of sorts. Her routine has little to do with work or taking care of her young daughter, but it is critical she do it. At least every couple of hours she checks her blood sugar level, “I have to watch what I eat and drink,” said Young.
Diagnosed at age 2 with Juvenile Diabetes, Young relies on insulin to keep her alive, “Literally everything I put in my mouth I take insulin for,” said Young.
A mother herself Young has been on her mom’s insurance most of her life. A state employee her mother is covered under Blue Cross Blue Shield. Katie Young has always used the insurance to purchase Humalog, once of several insulin options on the market.
That was until a recent visit to the pharmacy earlier this year, “She (pharmacist) said the insulin came back as my insurance was not paying for it, she said it would be $600,” said Young.
Young then contacted Blue Cross Blue Shield and says she was told they switched providers which meant a different insulin was considered the tier 1, less expensive option.
In most cases this is not a big issue but Young is allergic to the alternative option which is Novolog, “It starts to burn and (my skin) swells up right after taking it,” said Young.
Young filed an appeal with Blue Cross Blue Shield, but it was denied. Desperate for a solution her doctor gave her a few Humalog samples to get her by for a few weeks, “We don’t have enough money to pay (for Humalog) we are beyond paycheck to paycheck, at the end of the month we skimp trying to eat less,” said Young.
News 2 reached out to the State Treasurer’s Office who oversees the State’s insurance program. The agency declined our interview request and would only talk in general about how it administers the program.
We then reached out to patient advocate Thomas Nagle to look at Young’s situation and see if he could help, “Unfortunately this is an example of physicians not running health care, but insurance companies running healthcare,” said Nagle.
Young’s case while not common certainly does happen and for those people stuck trying to navigate the system when it does, it can be frustrating and at times very stressful.
In Young’s case the only options were pay sizeable upfront cost for the Humalog which she couldn’t afford, use the Novolog and deal with the pain and the rash that comes with it or plead with her doctor to provide her Humalog samples until she could figure it all out.
It took almost six months but eventually Young’s appeal was approved but since it was no longer the approved insulin the price was still too high, “This is life and death for me,” said Young.
Thankfully her doctors have assisted her with samples that will keep her going until December when she will switch to her husband’s plan.