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Dimitry K., Esq.
Dimitry K., Esq., Attorney
Category: Legal
Satisfied Customers: 41221
Experience:  Multiple jurisdictions, specialize in business/contract disputes, estate creation and administration.
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The insurance company wouldn't pay diabetes medicine.

Customer Question

The insurance company wouldn't pay for my diabetes medicine. They wanted me to try a cheaper medicine. I did and it didn't work. My blood sugar stayed between 200 and 300. Me and my dr told the Inuance co that the meds didn't work and they said I had to take it for 2 more months. But I can't have my blood sugar that high. For one I stay sick and the other DOT won't let me drive with bs over 200. They are basically forcing out of a job. Is this legal.
Submitted: 2 years ago.
Category: Legal
Expert:  Dimitry K., Esq. replied 2 years ago.
Thank you for your post. Please permit me to assist you. As someone who is also diabetic, I genuinely sympathize and understand your situation better than most. The answer that I will provide will likely not be favorable so I ask that you do not blame the messenger. An insurance company is only required to cover based on their own coverage limits and conditions. Provided that they have explained why they are denying the coverage (and there is good cause to do so), they are able to do so because you are still legally able to purchase medicine yourself, without coverage. The insurer is not required to cover all medicine or all procedures, merely up to their limits. You can request a formal letter of explanation and grounds, but I am afraid that not covering this type of medicine is not a violation (I just recently had a very similar situation with the glucose monitor and had to change to a new monitor myself). Sincerely, ***** *****