Diabetes Articles
  • Sign Up
FacebookTwitterDiggStumbleuponGoogle BookmarksRedditLinkedinPinterest

We won! A round of Novolog for the house please!


First things first - WE WON our grievance against Keystone Mercy Health Plan!

You remember the grievance, right?!! The one where, oh say Novolog, would not be 'medically necessary' for Grace. The one that stated she needed to try the formulary insulin, Humalog, before they would agree to step it on up to Novolog. Yeah, that one.

The representative from KM, a 'member advocate' which I found through the grace of God, called on Friday morning and said "I have great news, the medical director just approved Grace for Novolog. There will be no grievance hearing on January 25th (the one scheduled at 2 am, that was sweet) She's approved for 2 vials a month for one year, until January 2012."

I was speechless for one milli-second.
Then I screamed "YESSSSSS!!!!!" into the phone.
The advocate laughed.
Then she said, "You know, the medical director was only going to approve it for two months and I asked him, do you think this mom is not going to bring this up again in two months?? Then he agreed to a whole year!"
I wanted to kiss her, really, or at least a giant bear hug.

Cause this has been a S---load of work for me since I found out the denial.
But I was SO very ready.

I had, ready to go to the grievance hearing:
* A letter from Grace's endocrinologist on why she should stay on Novolog
* A letter from Gary, Grace's CDE, why she should stay on Novolog
* Two years worth of scripts for Novolog, printed out at CVS
* Two published articles about the difference between Humalog and Novolog
* A lawyer from the PA Health Law Project

I had all my bases covered. Completely.

And they folded.

I believe the current score is:

Penny - 1                Keystone Mercy - 0

Read Full Article

Find out if you qualify for discount Diabetic testing supplies, free offers or other running discounts at this time.


  1. First Name*
    Enter first name
  2. Last Name*
    Enter last name
  3. Phone*
    Enter valid US phone number
  4. E-mail*
    Enter email address



By submitting this form I authorize to be contacted by telephone. Please be assured that we value and protect your privacy. Co-Pays and Deductibles may apply.

About The Diabetes Network

The Diabetes Network was developed with the idea that people living with diabetes needed a central place to go for resources as well as get ideas, suggestions and encouragement. We have put a lot of effort into this website to make it easy and fun to navigate as well as informative so that you can have a voice when it comes to managing your diabetes. Please let us know how we can improve this website to better suit your needs.

More about our Mission

We're on a mission to make the healthcare community more technologically advanced than ever before. This website adapts to fit your tablet, iPad®, iPhone®, Android® or other smartphone. Just one of the ways we are working to make life easier for those living with Diabetes. Learn More...