My sister uses Medco to save on co-pays. She can get a three month supply of my niece's insulin and save on copays, though they will only ship out 600 strips at a time, no matter what the endo's prescription is, so she has to pay more copays for strips. We received warm insulin and Medco did agree to take it back and send us fresh. However, in the process of doing this, we were told that "due to a study by the Veteran's Administration showing that insulin is effective even if it comes to room temperature during shipping (their words, more than one person)" Medco will no longer deliver next day delivery. Period. Except in an emergency. I feel uncomfortable about this policy, as there are no exceptions, even for the hot summer months. Has anyone else experienced problems? P.S. We were out of town and called Medco to put a hold on the order (it had not yet shipped). We then called Medco two days ago, just to check and told them no one would be home to receive the insulin. They did agree to take the insulin back, but kept mentioning that lukewarm insulin was probably okay as they had shipped it a two and a half days ago and studies have shown insulin can stay at lukewarm temps for a short period of time.

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Wow. That would concern me as well.

I don't think they get that "probably okay insulin" is not good enough!
I don't have any experience with medco, but I have had problems with insulin I've bought at the pharmacy AND even with samples I've got from my doctor whose nurse told me they had just received them.

This was in the winter when things freeze, and my guess is that no one is taking very good care of insulin. I'm very insulin sensitive, so I'll see fluctuations in my response to insulin if it is half bad. Maybe people taking huge doses don't see as much difference, or don't know enough to blame the insulin when blood sugars rise.

Just today I heard from a friend who just got a bad Byetta pen--it was completely ineffectual--and she couldn't get the pharmacy OR the company to replace it. Her next pen worked fine.
I just received my first mail order refill from Medco, and my insulin was shipped via FedEx in an insulated package with two ice packs that were still cold when I opened the package. I don't know if it was next-day or two-day delivery. I called them due to an error with my test strip rx, and questioned the packaging on that refill (regular USPS) and was told that they ship medications the same way they receive them. If the manufacturer does not ship them in a temperature controlled package, then they won't either. Conversely, if they receive the medication in a temperature controlled package (like insulin) they will also ship it to their patients that way. She did tell me though, that if I wanted my test strips shipped differently that I could request it, but I imagine I would have to pay extra for it.
As far as the amount of test strips they will send out, it may also depend on your particular insurance plan and how much they allow on a monthly basis.
???? We use Novolog insulin. I understand their pharmacy fills the order. Medco used to allow next day delivery. Now insulin is only shipped two day UPS. Maybe it depends the representative you get on the phone?
We are allowed 15 strips a day; however Medco will only ship 600 at a time, so we have to remember to reorder and, of course, more copays. Novolog is filled by Medco's pharmacy, so it is shipped by them to us. They have changed their policy and do not allow overnight one day delivery anymore except in an emergent situation. So insulin is two days on the UPS truck even in the summertime. I don't remember how our first order arrived; just don't get used to Fed Ex overnight delivery; probably won't happen again. I was horrified with the way the Representatives indicated to me that lukewarm insulin that had been two days on a truck (in our case close to three days) is acceptable. They also mentioned this is the first time they "have had a problem with our order" so they would replace it. The problem occurred on their end as they shipped the insulin when we told them not to (twice). Apparently the "Veterans Administration Study" they kept quoting found that insulin shipped two days that had RECENTLY reverted to room temp was okay, as long as insulin was not at room temp for a long period of time. How we are supposed to surmise how long the insulin had been at room temp was not mentioned. I'm very unhappy about this policy, especially in the summer months. Medco will not even ship Fed Ex overnight to us at our own expense! Suppose I was newly diagnosed or took them at their word and accepted the shipment? Don't know if they would accept it back later on; doubt it. Then we would be out a three month supply. I am going to open a new bottle from each shipment from now on and test it immediately.
Lukewarm insulin? Not okay. I get insulin by Medco all the time and it's never been a problem, though.
This is our first problem with the insulin. But we get a three month supply at once so not willing to take the risk. Medco shipped the insulin to us when we had requested (twice) they not ship it as no one would be home to receive it. It then did arrive, but close to 9pm (Fed Ex does not deliver here past 7pm. Sis was calling UPS but not able to get a Representative on the phone once we learned it had been shipped in our absence). Next morning, insulin was at our door (UPS said they delivered 9pm evening before). So it was on our doorstep all night. I actually did check at 8:30 pm, but not after. Insulin delivered 8:57 pm Insulin was lukewarm. Medco did agree to take the insulin back but seemed to indicate insulin should be okay.
I have insurance that is like the old traditional insurance......PPO type. I use a pharmacy that will accept payment from insurance company as paid in full. IE: insurance pays 80%, they accept it and you do not have to pay. This only works with a PPO, not HMO where you have a co-pay. They send my insulin overnight, and I remind them to deliver before noon. No charge for this service. They ship even my oral meds next day delivery via Fed Ex. Contact me if you would like their info. They do a lot for diabetes fund raising, and offer test strips, some pump supplies, etc.
I am forced by my wife's employer to use Medco unless I want to pay full cost. My last shipment of insulin was 2 day and fine. I have had other issues with Medco and would gladly pay another 20% to use the Pharmacy up town. But I can't afford full price. My insulin was cool, not cold. That is April in Seattle, I see summer as an issue. Also, we get our deliveries at about 11; I get home at 5. That's a long time in the sun(only a concern here July thru August). Reading the insert I found that insulin stored above 46 degrees F or 8 degrees C needs to be used within 28 days. I guess I will be checking the temp of the vials as they come in the house. I don't expect Medco to listen but hopefully I can talk to someone at my wife's employer to get insulin uptown again.
Just a general comment on Medco. I had a major problem with them recently because I live out of country and buy stuff here in Guatemala and get reimbursed. They sent the checks to the wrong address and it was a months-long odyssey to straighten it out. I found that when I got truly irate and asked to speak to a Manager I then "latched on to that person" and dealt only with her in future conversations, both e-mail and phone. She walked me through it and even put me in touch with the people who control my payments (state of California) on an e-mail tree. I realized I should have gotten a single reponsible person from the start and my problem would have been solved.
I live in the same area, Mark, and get delivery to the door every 3 months. Again, I have NEVER had a problem with my insulin. Before you said it was lukewarm, now you are saying it was cool not cold. If the insulin was cool, then it is likely fine. And you should of course put it in the fridge immediately. Insulin generally will survive the shipping process as it is kept cold with those packs. You would have more trouble were it to freeze. Seattle does not get up into the 90 degree temps in july and aug - goodness we're darn lucky if it gets to 80. I think you should be okay. Medco is a fair company, and should you find your insulin has gone bad, then they will likely resolve the issue. Have you even tried the insulin to see if it is compromised? That would at least answer your worry.
If the insulin is lukewarm, which mine was, not "cool", lukewarm, my advice would be to call Medco immediately and report it as they would then most likely take the insulin back. If you wait to try a vial you have "accepted" the delivery. They shipped it 11am (according to first Rep I spoke to) on the 11th; delivered after UPS stopped making deliveries for the day in our area on the 13th at 9pm (more than 48 hours). In addition, it was placed on our doorstep after the hours UPS usually delivers and we found the insulin at 10am the next morning propped up against the door, doorbell not rung. When we called Medco twice and told them not to deliver until we arrived back home as no one would be there to receive the insulin, it was their mistake. And they did take back the insulin. Not sure if slightly chilled insulin works as well as it should, either. I assume the Veterans Administration study Medco quoted on lukewarm insulin being okay was tried out on Type 2s, who still have some functioning beta cells. Insulin worked much better for her when she was in her honeymoon and still had functioning beta cells. I doubt the relevance of the study Medco quoted for Type 1s.

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