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Does your health insurance offer benefits or cover services that adequately meet your needs?
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Here in Italy, like in most European countries, we have National Health Service, which is free (covered by general taxation) and covers our needs.
Hooray for Italy and most European countries. Maybe someday in the distant future, the USA will catch up.
Are ALL type 1 diabetes medications and supplies covered? At $0. At what percentage are you taxed?
For diabetes, yes, but Medicare in their wonderful wisdom, does not cover eye, dental or hearing so those are big expenses for me.
Kathy, you might be interested in a group that’s trying to expand Social Security and improve Medicare: https://pnhp.org/
Medicare Advantage plans do cover those
A combination of Medicare and a supplemental policy.
My needs are met through a combination of private health insurance and services provided by the Veterans Administration. The VA is my primary source of T1D supplies but my private insurance provides ophthalmologic care.
Tricare for Life denies inhaled insulin unless injected doesn’t work. I think I could benefit by treating the occasional sticky high with inhaled insulin—but it’s too expensive to pay completely out of pocket.
Ugh, Express Scripts is my PBM. made me dump FIASP and won’t cover Afrezza.
As stated by Gustavo Avitabile, most European countries have a National Health Service, which is covered by direct taxation. (I live in the UK, so my ‘insurance’ is our NHS (National Health Service).
There IS the option to take out your own private insurance, and some people do this as they don’t like NHS ‘queues’, but I’m in no position, financially, to be able to do that.
I live in Ontario Canada so I have no health insurance. I owned my own business and could not get health insurance due to a pre-existing condition (T1D).
I have several friends in the same boat. I have spoken to a number of T1D’s that took government jobs just to be covered under their group medical plan. In hindsight this probably would have been a good decision financially!!
Hmm. I always thought that Canada had a government health insurance program?
I’m retired. Have Medicare and a supplemental from my former employment. However, I have had situation where I could not get the services that I need. Once I went to get a stress test with contrast. When I got to the testing site, they gave me a paper to sign which said that Medicare will probably not cover the cost of this test. They wanted me to pay $1200 up front. i walked out.
Also, I have to buy my own eye insurance and dental insurance. I have no hearing aid insurance.
Medical and medication Medical Wheelchair also Dietetic Supplies
I am covered under my husbands federal health insurance and Medicare. Out of pocket costs somewhat inhibit me from trying a pump or Affreza. Like others mentioned, vision and dental are not covered.
In Washington State we elected a very rigorous Insurance Commissioner. See https://www.insurance.wa.gov/
And Kaiser Permanente, like Mayo & Cleveland Clinics, practices preventive medicine. So I get a discount on hearing aids, etc., BUT there are copays. And I pay for dental insurance, but it’s added to my monthly Advantage plan. I do get free gym membership because patients who exercise cost KP less. Next month I’ll take a free in-person Eccentrics class (see PBS) at Shoreline Senior Center, 20’ bus ride away. SO FIRST ELECT AN INSURANCE COMMISIONER WHO WILL SERVE CONSUMERS, ands who is NOT an insurance company stooge. I’d be much happier, though, with a non-profit health care provider as in Switzerland, or a state run non-profit health care plan: https://pnhp.org/
And https://www.psara.org/
I had Kaiser permanente in GA. They told me that unless I had an upper extremity disability or was an amputee, they do not cover the pens, only the vial. Same with medicare, they only cover the cheapest option, not the option that is best for the patient. Socialized medicine is not the answer to the healthcare issue in the USA.
I feel like I am discriminated against for choosing MDI with an InPen. I must pay co pay for two insulins and the InPen. Insurance charges a huge amount for pen needles. I get them mail order for a lot less. From Diathrive. I don’t understand why Medicare pays for a pump and also the insulin. And not for MDI. When I stop working will probably have to go back to a pump.
My only income is Social Security and I belong to an HMO. While my insulin was free with my previous insurance, the HMO is allowed to charge up to $35 a month, and they do. This was quite a shock at first, but I do appreciate the other economies they provide.
Medicare plus supplement that covers the 20%. Not an inclusive not an advantage plan. So far no problems with all my diabetic supplies or anything else. I pay zero copay and deductibles. Anthem plan f very happy with it.
Aha! Thanks for that info, Sherrie. So you chose Original Medicare & chose a Supplemental PLan? Sounds better than my KP Medicare Advantage Plan. Though it may involve seeing new doctors & much time changing my iPhone’s Contacts list, I’ve made an appt with a. SHIBA counselor to consider Original Medicare with a Supplement. Thanks for sharing. ❤️😎. My KP Endo doc & her team are only available on some days at some times. KP does NOT offer Original Medicare!
We have to make choices based on what we can afford and what the insurance company covers instead of what will help us achieve the best control. (Bad blood sugar control ultimately cost insurance company and diabetics more money in time as a result) Insurance companies negotiate prices with some companies and not others. It’s hard to anticipate what they will do year to year, which of your doctors will be dropped from coverage. Which medicines will stay the same price. An example- for a decade I was able to afford insulin, syringes and blood test strips, but not a pump (etc). Then the company insurance changed, I had to find all new doctors in-the new network, get new prescriptions filled, and found out that I now could qualify for a pump, but I could not afford the test strips that talked to the pump.
Now I’m anxiously awaiting the end of my 5 year medtronic 630 warranty so I can see if I qualify for IQ (or any smart pump that will keep my sugars level when I’m sleeping)
It’s a shame that Medicare doesn’t cover any of the emergency hypoglycemia products … if somebody knows different, please tell me how to make this happen! Thank you!
I just got a new glucagon kit (the type you have to mix) last year, the Medicare covered.
When I worked and with insurance was costly (stopped using a CGM several years) What I’ve learned since may have been less costly trying other systems, or looking at options.
Being on Medicare my Novolog should cost $35 per month but since it’s not what is on the formulary I pay $70 per month. All the rest of my DM supplies are $0 as long as I use what they say I can.
It is so stupid that insurance makes the medical decisions in this country, not the doctors.
Kristine, are you on Original Medicare with a Supplemental Plan? If so, are their other supplemental plans available? Is Humalog on the formulary? It’s similar to Novolog: fast acting.
Unfortunately, right now I don’t have health insurance. I’m very hopeful that by the end of October I’ll have completed the process to again have basic coverage.
Currently, I am on a plan with Cigna through the healthcare marketplace that covers my Humalog pens, Basaglar pens, and freestyle libre so that I pay $0. But everything else, including endocrinology visits are very very expensive.
Sometimes. As a diabetic who uses both a CGM and a pump., I use lots of supplies. My insurance gives me the exact number of supplies I need. With my pump and my insulin it is not as much of a problem because I spent an extended amount of time on prednisone and my doctor changed my prescriptions to have me change my infusion site every 2 days. I built up a supply of more than I needed. But my Dexcom is a whole different story. Dexcom has been good about replacing sensors when they come off early, but there are months when I come uncomfortably close with having to go without for a few days because . . . I don’t know why. They come off early and sometimes Dexcom doesn’t always replace them and the pharmacist Will Not Refill just because I am out of sensors, and even if they did, insurance won’t pay for it. You need to have back ups for all your supplies, including sensors, and it’s insane that you can’t have them. What if you run out on vacation? Too bad for you. You can have your prescription transferred to wherever you are, but after that, your endo or whoever writes your prescriptions will have to write a new one for your regular pharmacy because a prescription can only be transferred once. The whole thing is insane.
Anne, take heart. Doctors. patients, volunteers are uniting & working to eliminate high cost of middlemen, needless paperwork & data entry, and to improve benefits. Here are some links: http://www.pnhp.org/ http://www.psara.org/, http://wholewashington.org/
Are there similar groups in your state or a local chapter of physicians for a national healthcare plan?
Just wish they would cover my GLP-1 – Liraglutide
The health insurance coverage is great, but the processes PBMS and Medical Supply places use to provide DME and prescriptions for all diabetics is dangerous. Diabetics use varying amounts of devices and medications and the healthcare industry has a bias that assumes fixed amount of use (3 test strips per day for example or 1 infusion set cartridge every 3 days). This is not the way to manage our disease…. restricted by the number of devices/test strips we can use per day.
The insurance system is deliberately hostile toward our usage or being fully and correctly covered. Haphazard, entirely random insulin put in a specific coverage formulary, meters-strips fully covered in one period and refused coverage at some next random period. An openly hostile system against us period.