Samantha Walsh
Samantha Walsh has lived with type 1 diabetes for over five years since 2017. After her T1D diagnosis, she was eager to give back to the diabetes community. She is the Community and Partner Manager for T1D Exchange and helps to manage the Online Community and recruit for the T1D Exchange Registry. Prior to T1D Exchange, Samantha fundraised at Joslin Diabetes Center. She graduated from the University of Massachusetts with a Bachelors degree in sociology and early childhood education.
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How concerned are you right now about affording your next order of T1D supplies? Cancel reply
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I feel grateful to answer “not concerned”. I have Medicare and a supplement and my OOP expenses are low once my deductible is met.
I am on Medicare with a Supplemental and Rx policy. I am on the Omnipod 5, which Medicare does not consider to be a pump. So it goes on my pharmacy plan and the co-pay is 20%. That’s a lot.
I’m surprised you’re not being charged the $35 co-pay for one month of insulin, not 20%.
I answered “not at all concerned” because, for any month other than January, I have already met my part of our family’s deductible and my pump/CGM supplies are covered 100% but the first orders in January where I haven’t met that $600 deductible yet is expensive.
I answered not concerned because I understand the cost, not because the supplies will be budget-friendly necessarily.
I answered “other” because while I am not concerned about my NEXT set of supplies, I remember how insulin pries skyrocketed in the last decade. This week my insurance denied a prescription for Afrezza, saying my diabetes treatment is adequate as it is. As a result, I feel uncomfortable about access to better control. I remember a time when using more than 4 finger-sticks a day was not supported by my insurance company.
So it is a financial decision: do I simply pay for things out of my own pocket?
My employer offers a high deductible plan and even after the deductible we still pay 20%. The costs are brutal. I spend lots of time searching for coupons to make it more affordable. They are out there but I’m searching for them on my own and it gets a bit time consuming since 90day pharmacy won’t accept coupons so most of my supplies are 30day and I’m getting them refilled monthly in order to stay out of the poor house! So is life!
Fortunately, we have good insurance for our son, and a great supplement. Once we meet our deductible, the supplement covers our cost share.
Lets face it treating diabetes is expensive both for supplies and the complications it can bring. Thankfully the government has capped insulin at $35 otherwise the cost is almost $300 monthly. I’ve yet to find a part d plan that’s affordable and has good benefit. But I shouldn’t complain, before Medicare my insurance ran $800 monthly.
I know what you mean about not complaining. I am not on medicare yet, but I do worry what my prices for supplies will be once I am on it. Right now, everything for my diabetes supplies except my insulin is paid for 100%, but my monthly premium is a little over $500. That is a pretty penny for me, but luckily I am able to afford that.
Not at all concerned for insulin, pump supplies, and cgm sullies. The insurance company that covers my Medicare Advantage plan doesn’t list Baqsimi on their formulary so I co-pay $90.00 a pop with RX from endo provider. However, a T1D diabetes sister freind who lives in another part of NYS has a Medicare plan that does cover Baqsimi monthly at little co-pay or no cost so she sends me extras from her supply. It pays to have one or two “dia-buddies” in your support network.
Typo alert … cgm supplies, not sullies … I wish we had a widow to correct typos …
Not to be a Girl Scout expressing outrage over the organization’s commitment to cookies, but . . . I can afford the cookies. I am not as sure about insulin.
And I am not so sure I can afford this American health care of rickety for-profit, not-for-profit, non-profit, who can get what pound of flesh from whom, sometimes organized / sometimes disorganized health care system? Getting better? Yeah, but. ⛏🛠
I am always concerned that I might have to purchase a sensor if I have to remove one unexpectedly.
Although I selected “Not at all concerned” I thought I must explain that. I live in the UK (United Kingdom of Great Britain and Northern Ireland) where all of my diabetes supplies are paid for by our NHS (National Health System), which is financed via direct taxation of all working people that earn more than a basic level.
After 3 years on Medicare including Part B, D, and a supplemental I’ve finally learned that Part D is costing me so I’m disenrolling. I went to pick up a pump and they wanted about $500, because I have Part D but if I didn’t have it they would file it against Part B and be free!
I would look into that before you let it go because I was told if you don’t have part D you’ll get penalized for it. If you get it again I don’t know more things to look at but my pump and all my supplies go under part B I pay nothing because I have a supplement, Blue Cross anthem plan F
I’m 53, not worried for the next set of supplies, BUT very concerned as each year goes by that Medicare will never get their act together for diabetes care. 65 is not too far away anymore, and the pace of any government change for the good of the people is slow at best.
We responded not concerned, but we are toward the upper income level or those with diabetes, Many are very worried. As a social worker I’ve met many who could not get insulin or supplies. We need universal health insurance and could pay for it by removing all of the complex systems to get care. Why do we need to have “Health Care Advocates” paid full time to help people get health care? NO universal care.
With no insurance since I retired I paid an average $190-200 for insulin and a CGM (Libre3) through Amazon and GoodRX at Wal-Mart. With that said a week ago ordered a 2nd order through the VA pharmacy. Unsure if this idiot did it right, was counting out the units, test strips, and the last prescription for the CGM when the insulin arrived; just got a notification the rest is enroute.
With that said I think it’d be foolish never to think about supplies.
If you’re still uninsured-go to the website of the insulin manufacturer that you use OR call them, and they’ll send you a voucher to get insulin for $ 35/month. You must be uninsured & paying cash to qualify. Abbott (Libre) & Dexcom also have reduced prices for the uninsured- call them !
My costs are covered by the UK National Health Service
Deadly afraid. Two insurance companies both deliberately denying they are “primary”. Both now refuse to pay for anything even the mandatory stuff.
🙁
Not concerned at this time…will be retiring in 3 years and starting to do research on what needs to be done and what the costs will be.
Very concerned because I must get CGM supplies through mail order with a medical supply company. I’ve been using Solara (which is owned by Adapt Health) and they’ve repeatedly overcharged me for supplies. I’m looking for a new supplier- any suggestions ??