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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Have you had to pay out of pocket for back up T1D-related supplies? Cancel reply
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Most of my supplies are covered by Medicare and my supplemental insurance. But, I have to pay the annual deductible, $250.
Byram unreliable
I would have to pay out of pocket so I don’t have any backup supplies.
Same here!
Medicare through a supply company here but they do not always send on time or have trouble getting them on time so I occasionally have bought a sensor on my own with no insurance help to hold me over because it isn’t worth the rigamarole to get it on time.
I use my pharmacy for Dexcom G7. Like it better. Don’t like being at mercy of mail order.
They try to make me but I refuse. I fight and normally win. Have had to fight only since going to Medicare. You have to have the TIME to fight for yourself. It takes hours on the phone. But since retiring, I have the time. Sometimes it’s just a matter of who is going to submit the paperwork. My pharmacy fights over stuff like that with my endo’s office. I just keep driving from the office to the pharmacy until they are embarrassed (my endo’s office because I just show up and talk loudly so everyone in the office can hear me) or they give up because they know I will not. Very frustrating. The squeaky wheel and I’m sure they think I am obnoxious. I don’t care what they think.
TIME is money. If you value your time, how much are you spending? 💰
Not sure what you mean by back supplies. I pay co pay for insulin and InPen. Changing to tandem pump as soon as all paperwork finished. Not sure what co pay will be.
I’ve chosen to simply because the supplies weren’t terribly expensive (<$30 USD), I'm not on a fixed income, and the hassle of getting reimbursed would take more time than the supplies cost.
insurance doesn’t cover glucagon.. so $300, It also doesn’t cover back up test strips when on dexcom, need those to calibrate or check if the dexcom is accurate on the first 2 and last 2 days.. those are about $60 a month, syringes, alcohol swabs. Doc recommended also having back up NPH in case the pump fails, but I cant afford to keep that supplied up.
I have to pay for Baqsimi because it not covered by my Medicare drug plan. I also bought a backup G7 sensor because Medicare only covers 9 sensors for 90 days and things happen. Fortunately, I’ve been able to accumulate enough of my other supplies over the years to feel I’d be safe in an emergency.
When I didn’t have insurance a couple of years ago I had to pay out of pocket for everything. I’m grateful to have good insurance now.
More than 40 years ago ABIR
On more than one occasion I have had to but CGM sensors because they expire too soon or one of them malfunctions and I don’t have another. Insurance won’t allow me to refill it early.
I buy my own test strips because my insurance doesn’t cover the Contour Next strips. I did a study and was given this meter. It’s very accurate and so much better than the one ins pays for. Costs about $30 / month.
Same here. The Contour Next is the best and most accurate. Prior to Dexcom G6, if I had a low alert (or high alert) I would do the obligatory fingerstick. I was also a 15-20 fingersticks a day person anyway (many because I checked whenever I was going to drive). The meter would read – as an example 180 when my Dexcom was at 70 with a downward arrow.
Fortunately, I was on the invite list for ENDO CME. At one session the issue of accuracy in home monitors was discussed. Turns out the meter my health plan covered was shown (Diabetes Tech Society AACE) to read higher than actual for people with chronic anemia. So 15-20 fingersticks a day and I was having major lows. After taking home hard copies of the reports, I did my own comparison. Turns out the Dexcom and the Contour Next were very close. I was safer dosing from the Dexcom than from the One Touch. So I pay out of pocket for Contour
About once a year I buy a 3-sensor box for my Dexcom, and a vial or two of humalog. Just to be safe.
I don’t think I have any backup supplies except for insulin. The doctor writes an rx for insulin based on an estimate of usage. So I end up with extra.
Only one time did I have to purchase out of pocket Dexcom sensors when going on Medicare no one told me how long the switch would take and all the hoops you have to jump through including having to get the C-peptide test proving I really needed the insulin I had been taking the previous 23 years.
Yeah, kinda the same for me (see my comment). I never had antibody or c-pep tests back when I was dx’d in 1983–AFAIK they weren’t even a thing. I’d gone from zero to DKA in about six weeks. It wasn’t a hard call. Big trepidation b/c the one time I did get c-pep tested it was normal range, but that wasn’t under the guidelines of fasting, time of day, etc. When I did have it re-tested it was way low. Not zero–some of us still produce some residual insulin–but well below the Medicare cut-off. Still, it’s kind of an insult. 40 years dealing with this every minute of my life, through every insulin regimen known to man, and suddenly I gotta PROVE I’m T1??? Just ask the endos I’ve been seeing the last several DECADES.
I forgot about test strips. I have to purchase them and my meter because I have Dexcom and Medicare won’t pay for test strips anymore .
Bought a box of Mio Advance insets back when I moved states and couldn’t get lined up with a new endo in time for Medicare to fill my script. Thinking about buying another box b/c I’ve switched to Tandem and they use the old-school Mio thwacker, which often hurts and results in bent cannulas far more often than the Advance does. Turns out you can use the Tandem tubing with an Advance inset, as the clips are identical. So there’s some wastage involved, but I only use them when I’ve run into problems with the Mio. Wish they’d all use standardized connectors at the pump end so we could choose, but that would be a heresy against capitalism apparently.
I mean… I always pay “out of pocket” b/c Insurance does not cover all costs. But I think the question means to ask “Have you paid outside of your insurance plan” or something like that. For me, I did it recently for the first time b/c Amazon Pharmacy (I’m a new member) said that the cost for 3 boxes of Dexcom sensors was over $300, when I use my insurance, but only $67 when I didn’t. Guess which I chose?!
I am in between jobs and have been paying cash price for supplies over the last 4 months. Insurance coverage for the new job doesn’t begin for another 30 days. I have found that cash pricing can vary. Don’t be afraid to shop around. I usually pay about $100 for a box of G6 Sensors. About $150 for a month of infusion sets.
Whups… I conveniently ignored the part where the question asked “back up” supplies. Only once… I was heading on a cruise and realized I had left my meter at home. So I bought a new meter and strips at Walgreen’s “just in case” my Dexcom failed. Meant to return them when we got back from the cruise, but I never did so… yeah, now they’re hanging around in my closet.
All the Blooming time. Ambetter doesn’t cover anything essential for type 1 diabetes – Fiasp no, dexcom no, baqsimi no, BG strips not in the quantity needed.
I marked “Other”. My backup supplies are a long-acting pen which my endo provided and test strips (which I try to keep extra on hand). I’m sure I would have to pay for any backup supplies as I pay for all diabetic supplies now.