18 Comments
Compared to a year ago, how much has your out-of-pocket cost increased for T1D devices and supplies?
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Since I switched to the Omnipod 5, the formerly “durable medical equipment” status of the old Omnipods now switched over to a “formulary” (allegedly by the FDA) and now I pay the high tier amount of $50 a month for my replacement Pods. Thus my out of pocket increases accordingly. [Fortunately my Endo prescribes me with more than enough each month, which allows me to have extras.] You never know when one might get ripped off during work activities.
A year ago I had a Part D plan that cost me about $68 per month but I had no copay on insulin. That plan was discontinued and I now have one that costs me $38 per month and $35 copays for insulin. Since I take two different insulins, my total cost has gone from $68 to $108, an increase of 58.8%.
Supply benefits are stable ie pumps, tubes, sensors. Rx co-pay, however, are rising incrementally.
My co-pays for insulin have gone up, but since I don’t remember past costs, I can’t say how much the cost has increased
My costs have gone down, due to the cap on insulin.
The big increases were several years ago.
I think mine are less last yr and maybe even less this yr, on Medicare advantage and drugs are less
last year I reached my OOP max due to an operation so last year’s costs were very low
Just switched to pump after MDI. Supplies are no copay. Insulin is now only $35 for one type compared to needing two different insulins. Also paid deductible for my InPen which won’t have any more. So I guess saving some
Not much, but I am not sure by how much.
I am extremely lucky, my pump and CGM supplies are covered 100%, my insulin pump is covered by an 80% / 20% co-pay thank goodness. My Novolog co-pay even went down in price by about $20 per month, making $53 and change.
We switched to a lower cost plan at the beginning of the year because we were told everything would still be covered. My out of pocket cost has risen considerably on the new plan. We will switch back next year. Live and learn!
My deductible went up significantly and my percentage of co-pay went up from 20% to 30%.
After two year of trying, I finally got my first vial of insulin under Medicare Part B. Last year Medicare granted me an exemption because I could not locate a pharmacy to fill my Part B prescription and I went back to pard D at quite an expense.
My medications co payhave gone up significantly.
The pharmacies are blocking access to required supplies if billing to Part B Medicare, by using outdated documentation requirements that MDs cannot provide because charts do not include the info in the format requested any longer, so pharmacies refuse to submit billing for covered supplies in the required amount…examples include specific insulin, test strips, which require out of pocked purchasing to get the necessary supplies. This is not Medicare, it is outdated data requirements asked for from an MD that are no longer documented in med records. The extra work has caused MDs to state that part b covered supplies are no longer covered, yet Medicare says they are.
My OPE has gone way down. Insulin and needles are now covered in full. In the past I paid $90 every 90 days or so.
Answered not sure. This past year switched from private insurance to Medicare parts A, B, and D. The perpetual problem with insurance is determining the cost of anything. Premiums, co-pays, deductibles, discounts, coupons, changing rules with pharmacy benefit managers. Medicare has decent coverage. I believe overall costs have risen, but I’m not going to calculate year-over-year expenditures for this survey.
I am newly diagnosed within the year. The amount I pay is less than I was warned. With that said, my opinion is that T1D supplies should be free.