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    • 3 hours, 19 minutes ago
      Greg Felton likes your comment at
      If you were to request the next available appointment with your T1D healthcare provider, when do you estimate the next available appointment would be?
      Before the onslaught of Type 2 Diabetes, I, as a T1D, could get an appointment almost anytime I needed one. Now, I cannot get an appointment within 3 months, which is the time within I must see rhe doctor for Medicare benefits. My doctor cancelled 2 (half ) of my sppointments last year. Caused ma a lot of problems. I live in Florida, a place where modern medicine does not seem to have reached yet.
    • 3 hours, 20 minutes ago
      Greg Felton likes your comment at
      If you were to request the next available appointment with your T1D healthcare provider, when do you estimate the next available appointment would be?
      I routinely see my Endo every three months. At the end of my appointment I schedule the next quarterly meeting date. But if I ever have to reschedule it, then it takes anywhere from two to four weeks to find a time that works for us.
    • 5 hours, 16 minutes ago
      Mike S likes your comment at
      If you were to request the next available appointment with your T1D healthcare provider, when do you estimate the next available appointment would be?
      It all depends on the urgency of my needs. I’ve gotten in the next day before, but those days may be gone! It also depends on who I see. But these days, even the PA is often booked. Of course, cancellations happen, so that can be a factor as well.
    • 5 hours, 32 minutes ago
      Jeff Marvel likes your comment at
      Over the past 3 months, how much time would you estimate you have spent working through T1D prescription-related issues with pharmacies, insurance companies, durable medical equipment distributors, T1D device companies, health care providers, etc.?
      The beginning of the year is always a bit iffy when you're on Medicare. Even though I've already paid my annual deductible, my pharmacy can't see that, so I must wait until it shows up on my Medicare account before I order new insulin. I always try to have plenty of insulin on hand at the end of December so it's not an issue. The organization I get my pump equipment from has a lot they must do because of Medicare, as well, and that can get time consuming. All-in-all, I'm lucky to have the time, energy and patience to deal with it, and I know up front these time-consuming moments are to be expected. If I wasn't retired, it'd be more of an issue.
    • 16 hours, 43 minutes ago
      Gerald Oefelein likes your comment at
      Over the past 3 months, how much time would you estimate you have spent working through T1D prescription-related issues with pharmacies, insurance companies, durable medical equipment distributors, T1D device companies, health care providers, etc.?
      I selected 6 hours. So far, I have spent 6 weeks trying to get a new pump. I decided to look for a new pump in mid-December as my 770G warranty expired on January 3. I wanted to go hoseless with the Omnipod and the Dexcom 6. I contacted Dexcom and they sent me to the medical distribution company ASPN, and they could do the Omnipod but only with pharmacy part D with the Dexcom 6 sensor on DME My part D pharmacy plan had Omnipod as tier 6. $155.56 co pay and $150/month. The omnypod is not available as DME. I called INSULET the mfgr of omnipod. They told me they only supply via pharmacy plan to get more T2d's to sign up. Verses 100% DME coverage, part D coverage that was a non-starter. I contacted another supply company CCSmed. They could do both Dexcom 6 and tslim x2. Ineeded a Endo visit to get the notes and Rx. I had my Endo visit on Jan 20. Still waiting for CVSmed. Been waiting for 5 weeks now. Just called CCSmed and they got the endo notes and Rx but Medicare wanted to know who paid for my 770G 4 years ago. Fortunately, that was private/company. My new pump should now ship tomorrow. Finally.
    • 20 hours, 31 minutes ago
      Wanacure likes your comment at
      Over the past 3 months, how much time would you estimate you have spent working through T1D prescription-related issues with pharmacies, insurance companies, durable medical equipment distributors, T1D device companies, health care providers, etc.?
      Most of the 3-4 hours is way ting on a phone
    • 20 hours, 34 minutes ago
      Wanacure likes your comment at
      Over the past 3 months, how much time would you estimate you have spent working through T1D prescription-related issues with pharmacies, insurance companies, durable medical equipment distributors, T1D device companies, health care providers, etc.?
      I answered "No time," but I live in France, where we have a single provider. I receive a prescription from my doctor and go to the pharmacy monthly to have it filled. (Pump peripherals are provided by a separate supplier.) "Appeals" do not exist here since the doctor will only prescribe medicines that are reimbursed. And no, I have never needed a treatment that wasn't covered.
    • 21 hours, 16 minutes ago
      Wanacure likes your comment at
      When you experience an illness that makes your blood glucose levels more difficult to manage (whether because you are unable to eat, the stress of being sick, or any other reason), what resources do you refer to for help managing your blood glucose levels while sick? Please select all that apply to you.
      The resources I use in managing my glucose levels once sick is my own personal experience after living with t1d for 46 years
    • 21 hours, 16 minutes ago
      August Rossano likes your comment at
      Over the past 3 months, how much time would you estimate you have spent working through T1D prescription-related issues with pharmacies, insurance companies, durable medical equipment distributors, T1D device companies, health care providers, etc.?
      Switching to Medicare has created (seemingly) endless hours and day making this transition with all things diabetes related. We’re still in the midst of making this ā€˜delightful’ change. This week we learned that Medicare covers Either CGM stuff OR glucose test strips. Thank goodness that God is sovereign over all these details. He helps me walk through these challenges without despair.
    • 21 hours, 18 minutes ago
      August Rossano likes your comment at
      Over the past 3 months, how much time would you estimate you have spent working through T1D prescription-related issues with pharmacies, insurance companies, durable medical equipment distributors, T1D device companies, health care providers, etc.?
      The last 3 months have been filled with frustrating phone calls now that I switched back to traditional Medicare from a Medicare Advantage plan. I have been fighting to get strips authorized in addition to CGM- they did not authorize them because I had no proof that I had a meter!! Crazy making! I had to write an appeal letter in order to get them, but finally got it worked out. I also had some pump replacement issues, trouble getting insulin, etc.
    • 21 hours, 23 minutes ago
      August Rossano likes your comment at
      Over the past 3 months, how much time would you estimate you have spent working through T1D prescription-related issues with pharmacies, insurance companies, durable medical equipment distributors, T1D device companies, health care providers, etc.?
      I answered "No time," but I live in France, where we have a single provider. I receive a prescription from my doctor and go to the pharmacy monthly to have it filled. (Pump peripherals are provided by a separate supplier.) "Appeals" do not exist here since the doctor will only prescribe medicines that are reimbursed. And no, I have never needed a treatment that wasn't covered.
    • 21 hours, 24 minutes ago
      August Rossano likes your comment at
      Over the past 3 months, how much time would you estimate you have spent working through T1D prescription-related issues with pharmacies, insurance companies, durable medical equipment distributors, T1D device companies, health care providers, etc.?
      Much too much time! Part of it, I know, is my own fault, for not keeping anxiety at bay when I have to sort out which plan will work best, annually. But it is something I dread, every single year. When I call to get some help understanding, the people are almost always very nice, but I have had times when the information was incorrect or not explained clearly. I usually commiserate with the person on the phone for having such an annoying system, and agreement seems to rule the day. But I never chose to make sorting out insurance management a career!
    • 21 hours, 25 minutes ago
      August Rossano likes your comment at
      Over the past 3 months, how much time would you estimate you have spent working through T1D prescription-related issues with pharmacies, insurance companies, durable medical equipment distributors, T1D device companies, health care providers, etc.?
      I selected 6 hours. So far, I have spent 6 weeks trying to get a new pump. I decided to look for a new pump in mid-December as my 770G warranty expired on January 3. I wanted to go hoseless with the Omnipod and the Dexcom 6. I contacted Dexcom and they sent me to the medical distribution company ASPN, and they could do the Omnipod but only with pharmacy part D with the Dexcom 6 sensor on DME My part D pharmacy plan had Omnipod as tier 6. $155.56 co pay and $150/month. The omnypod is not available as DME. I called INSULET the mfgr of omnipod. They told me they only supply via pharmacy plan to get more T2d's to sign up. Verses 100% DME coverage, part D coverage that was a non-starter. I contacted another supply company CCSmed. They could do both Dexcom 6 and tslim x2. Ineeded a Endo visit to get the notes and Rx. I had my Endo visit on Jan 20. Still waiting for CVSmed. Been waiting for 5 weeks now. Just called CCSmed and they got the endo notes and Rx but Medicare wanted to know who paid for my 770G 4 years ago. Fortunately, that was private/company. My new pump should now ship tomorrow. Finally.
    • 21 hours, 26 minutes ago
      August Rossano likes your comment at
      Over the past 3 months, how much time would you estimate you have spent working through T1D prescription-related issues with pharmacies, insurance companies, durable medical equipment distributors, T1D device companies, health care providers, etc.?
      The beginning of the year is always a bit iffy when you're on Medicare. Even though I've already paid my annual deductible, my pharmacy can't see that, so I must wait until it shows up on my Medicare account before I order new insulin. I always try to have plenty of insulin on hand at the end of December so it's not an issue. The organization I get my pump equipment from has a lot they must do because of Medicare, as well, and that can get time consuming. All-in-all, I'm lucky to have the time, energy and patience to deal with it, and I know up front these time-consuming moments are to be expected. If I wasn't retired, it'd be more of an issue.
    • 21 hours, 26 minutes ago
      August Rossano likes your comment at
      Over the past 3 months, how much time would you estimate you have spent working through T1D prescription-related issues with pharmacies, insurance companies, durable medical equipment distributors, T1D device companies, health care providers, etc.?
      I said 8+ and the reason, as for so many others, can be summed up in a phrase: transitioning to Medicare.
    • 22 hours, 2 minutes ago
      Wanacure likes your comment at
      On a scale of 1-5, how satisfied are you with your current insulin delivery method (pump, pens, syringes, inhaler, etc.)? 5 = the most satisfied, 1 = the least satisfied
      I’m a reasonably satisfied MDI user with Lantus and Fiasp. I’ve looked into getting a pump but honestly, until I find one that does everything I want, I’ll probably hold off. My wish list for a pump: 1) no tubes 2) works well with Fiasp 3) controls that allow me to stay at my target of 70-90 mg/dl all night long.
    • 22 hours, 13 minutes ago
      Wanacure likes your comment at
      On a scale of 1-5, how satisfied are you with your current insulin delivery method (pump, pens, syringes, inhaler, etc.)? 5 = the most satisfied, 1 = the least satisfied
      MDI for the past 60 years and do not see any alternative that I would prefer. The needles for my pens are so thin and sharp that they are painless (a far cry from the lancets I once used). chiefly, I am glad not to have to deal with setting up a pump and. Although I love my libre, I am not good candidate for having devices affixed to me. If my insulin delivery got interrupted they way i have interrupted my cgm service, I would have been in trouble. Furthermore, I have a track record of having both mechanicall and electronic things malfunction. (Seriously, I sometimes act as a beta-tester for technology folks. Maybe I push to many buttons?)
    • 22 hours, 25 minutes ago
      Wanacure likes your comment at
      On a scale of 1-5, how satisfied are you with your current insulin delivery method (pump, pens, syringes, inhaler, etc.)? 5 = the most satisfied, 1 = the least satisfied
      I've had Tandem x2 and Dexcom since September. Previously on Medtronic for around 15 years. Grew to HATE the sensors and switched before the warranty on my last Medtronic was up. So far, I absolutely LOVE the Tandem and the Dexcom. I'm disappointed, however, in the amount of waste and plastic that this pair creates. Of course there will always be plastic waste from any pumps/sensors, but the amount of non-reusable stuff for insertions is ghastly.
    • 22 hours, 26 minutes ago
      Wanacure likes your comment at
      On a scale of 1-5, how satisfied are you with your current insulin delivery method (pump, pens, syringes, inhaler, etc.)? 5 = the most satisfied, 1 = the least satisfied
      Have your doctor prescribe the syringes with .5 unit increments instead of the 1 unit syringes. Not quite a .1 unit which you are hoping for, but .5 is better than 1 unit increments.
    • 23 hours, 41 minutes ago
      Ahh Life likes your comment at
      Over the past 3 months, how much time would you estimate you have spent working through T1D prescription-related issues with pharmacies, insurance companies, durable medical equipment distributors, T1D device companies, health care providers, etc.?
      I answered "No time," but I live in France, where we have a single provider. I receive a prescription from my doctor and go to the pharmacy monthly to have it filled. (Pump peripherals are provided by a separate supplier.) "Appeals" do not exist here since the doctor will only prescribe medicines that are reimbursed. And no, I have never needed a treatment that wasn't covered.
    • 1 day, 1 hour ago
      ConnieT1D62 likes your comment at
      In your own words, how would you describe the feeling of a severe low?
      Nothing short of terrifying. I often go into seizures, having no idea where I am, who anybody, or even if I’m alive or dead. I’ll feel like I’m falling or hurtling toward something. At home I feel like my house is tilting. Im leaving a lot out but these are some of the scariest things.
    • 1 day, 1 hour ago
      Modee likes your comment at
      Over the past 3 months, how much time would you estimate you have spent working through T1D prescription-related issues with pharmacies, insurance companies, durable medical equipment distributors, T1D device companies, health care providers, etc.?
      Most of Europe has the right idea! Is it a good health system for you overall? The US may be too large to implement a national system, but that doesn't hold states back (as long as there is federal money to help).
    • 1 day, 1 hour ago
      Modee likes your comment at
      Over the past 3 months, how much time would you estimate you have spent working through T1D prescription-related issues with pharmacies, insurance companies, durable medical equipment distributors, T1D device companies, health care providers, etc.?
      I answered "No time," but I live in France, where we have a single provider. I receive a prescription from my doctor and go to the pharmacy monthly to have it filled. (Pump peripherals are provided by a separate supplier.) "Appeals" do not exist here since the doctor will only prescribe medicines that are reimbursed. And no, I have never needed a treatment that wasn't covered.
    • 1 day, 1 hour ago
      Modee likes your comment at
      Over the past 3 months, how much time would you estimate you have spent working through T1D prescription-related issues with pharmacies, insurance companies, durable medical equipment distributors, T1D device companies, health care providers, etc.?
      I said 8+ and the reason, as for so many others, can be summed up in a phrase: transitioning to Medicare.
    • 1 day, 1 hour ago
      Modee likes your comment at
      Over the past 3 months, how much time would you estimate you have spent working through T1D prescription-related issues with pharmacies, insurance companies, durable medical equipment distributors, T1D device companies, health care providers, etc.?
      PUMP USERS: Just in case nobody has told you, if you use a pump, Insulin is considered durable medical equipment, which can save a lot of money, even with the new price cap
    Clear All
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    How well do you understand the details of your health insurance coverage (e.g., which medications are covered, how much a service will cost, the steps you need to take about getting a service or product covered, etc.) Please select the number or statement that best represents your knowledge.

    Home > LC Polls > How well do you understand the details of your health insurance coverage (e.g., which medications are covered, how much a service will cost, the steps you need to take about getting a service or product covered, etc.) Please select the number or statement that best represents your knowledge.
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    If you use an insulin pump, please select the option which most accurately completes the statement for you: The last time I changed my pump site, I filled my reservoir/cartridge/pod with enough insulin to last me...

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    28 Comments

    1. Ahh Life

      Maybe I am just a delicate scold who get the vapors over things like knowledge and understandability. Or maybe I simply have a brain of cinder-block denseness. I dunno.

      But I am intrigued by those of you who answered 5, ā€œfull or clear understanding.ā€ My medicare book alone has about 2,000 pages. My supplemental insurance has only slightly fewer pages.

      The larger problem it would seem is a reminder of just how much we’ve acclimated ourselves to the presence of awful legalistic hour-glass capitalists into our collective health care that choke off everything but profits and abundant CEO salaries.

      18
      2 months ago Log in to Reply
      1. Lawrence S.

        Perfectly said.

        3
        2 months ago Log in to Reply
      2. Andrew Stewart

        Private insurance is not all that complicated to understand. I’m not looking forward to medicare and when I do my response will surely change.
        #BeWell

        1
        2 months ago Log in to Reply
    2. Debbie Dallmann

      I have been blessed with extremely good insurance and secondary to cover whatever I need.

      2 months ago Log in to Reply
    3. GLORIA MILLER

      I have Medicare as primary and almost never check to see what is covered under that plan. My secondary coverage is with federal Blue Cross Blue Shield and I know they will pick up anything that Medicare does not cover. My mother, who died in 2019 with lung cancer, had the same insurance and never paid a dime out of pocket for her medical needs.

      1
      2 months ago Log in to Reply
      1. Kris Sykes-David

        I am turning 65 in February and will be doing the same. My husband was the Federal employee. We decided to keep Fed BC/BS instead of switch to an Advantage plan. I hope it works, it has for him!

        2 months ago Log in to Reply
    4. Barbara Bubar

      The real trick comes when you call –in this case, a Medicare Advantage Plan company—to ask a question. THAT is a time consuming nightmare of transfers and waits to try and get someone who can figure out a possible answer. We happen to be fortunate to have an excellent local representative with the company and she has us contact her —but just how many of us does she have the time to help? The plans are all, as said above, SO complicated and they change every year. How can any phone representative keep up with the changes??? They cannot.

      2
      2 months ago Log in to Reply
    5. Lawrence S.

      I feel that I have a basic understanding of my Medicare and Secondary NYS Gov’t Empire Plan. I am always surprised at how much I have to pay after my primary and secondary get through. My copays are usually larger than I expect. I’m tired of fighting with them.

      2
      2 months ago Log in to Reply
    6. Jane Cerullo

      Made a mistake choosing the wrong plan for me. When I was able to reenroll I researched several plans and was happy with the plan last year and will continue to use this year

      2 months ago Log in to Reply
    7. pru barry

      I spent nearly all yesterday afternoon with the “book” and online, and on the phone when I’d finally reached a decision. There used to be a group to help seniors with this, but two years ago the person who tried to help was at much at sea as I am. So now I do it alone, with the idea that if I wind up with no coverage for the supplies needed to keep my 69 year use of needles and pumps alive, I will reinforce my whining with a scream they might be able to hear. The whole scenario is a disgrace, and the insurance companies should be mortified. But…..apparently they aren’t. Nothing really happens, and each year is torture.
      Thank goodness for trees, birds, and soft breezes!

      8
      2 months ago Log in to Reply
    8. Marty

      I spend a lot on Medicare and a Medicare supplement that completely covers copays and deductibles for all Medicare-approved healthcare. It took a while, but I finally have a good understanding of what Medicare approves. I also pay for a supplemental drug plan with a complicated tier coverage system, which I have to research for every new drug. My longtime endo had a problem with the Medicare requirement for face-to-face visits every 90 days so I had to find a new endo who would take me on. It also took a long time to find an insulin supplier who would/could bill Medicare Part B properly. As I said, it look a lot of effort to figure out how to use my Medicare benefits but I think I finally have things under control.

      1
      2 months ago Log in to Reply
      1. Liz Avery

        Ditto. The proper insulin supplier was a hang up for me for a year. I too think I have things under control finally.

        2 months ago Log in to Reply
      2. Bill Williams

        With traditional Medicare, a Medigap (supplement) policy and a Part D plan that fixes my insulin co-pay at zero all the way through the donut hole, my annual cost is essentially fixed. It’s not cheap, but at least I don’t get surprised.

        2
        2 months ago Log in to Reply
    9. Nevin Bowman

      My experience: the doctor can choose which insurance to accept, the insurance can choose which doctors and medications to cover, and I the patient, have zero say in any of that. Meanwhile, I pay a fortune to have almost no rights.

      4
      2 months ago Log in to Reply
    10. skoogirl

      I understand health insurance very well. I read the fine print. I have to fight tooth and nail for them to cover things that the policy clearly covers. I have contacted health advocates at work to get things added to the formulary. I routinely file appeals. Our current system puts the consumer at a disadvantage and the insurance companies seem to know that most people give up after the first “no” and take advantage.

      4
      2 months ago Log in to Reply
      1. Ms Cris

        Exactly. In my other career, I learned how to get insurance companies to fulfill their end of the bargain, ask the same question in different ways, etc. I apply those same principles to this now!

        2 months ago Log in to Reply
    11. Steve Rumble

      I have had the same basic coverage through Kaiser for 33 years! During that time I have learned the ins and outs of the coverage and where to find additional information if needed.

      2 months ago Log in to Reply
    12. Kristine Warmecke

      What I don’t understand and need clear understanding of is the Insulin Act. Does ANYONE understand it, including the lawmakers who wrote and voted on it?

      1
      2 months ago Log in to Reply
      1. Lawrence S.

        I researched it a while back. My understanding is that effective January 1, 2023, if you are on Medicare the cost of insulin is $35 per month.
        Unfortunately, if you are not on Medicare, there is no cap.

        The political side of that I that the Democrats wanted full discounts for everyone. Almost all of the Republicans voted against it. The Medicare patient coverage was left untouched.

        2
        2 months ago Log in to Reply
      2. Ms Cris

        LMAO! They do not understand T1 is not “T2 you’re born with”…that’s it’s literally life or death for us. They are lobbied to heavily to change profit margins for pharma.

        I write my reps and senators 2x per year each about it.

        The U.S. system is so broken. I’m a dual citizen, and in the other country, most of what I need is free, including insulin. Unfortunately, it’s too far to ship that much insulin safely.

        1
        2 months ago Log in to Reply
    13. Kim Murphy

      I understand it perfectly it is horrible when it comes to covering diabetes and it’s associated costs. I pay $350 a month to have it and it covers nothing until my $6000 deductible is met!

      2
      2 months ago Log in to Reply
    14. Janis Senungetuk

      Every year it gets harder to understand. I’m covered under my spouse’s employer (a hospital) with primary insurance that costs a huge portion of each paycheck. Last year, without any warning, increased my cost for DME by 40%. My secondary insurance is original Medicare. Although they’re secondary, my DME orders are limited by Medicare rules, creating the constant stress of running out before the next shipment. I wouldn’t wish this very broken health CARE system on anyone.

      3
      2 months ago Log in to Reply
    15. Lawrence S.

      Here’s a perfect example of what just happened to me minutes ago. My doctor prescribed Omeprazole tablet 20 mg for me in April, 2022. My drug company, CVS/Caremark, told me they are not covered, I must buy the over-the-counter. I just received the 2023 Formulary, and it shows Omeprazole as a covered drug. I called CVS/Caremark, and they said that the Omeprazole would have been covered if the doctor has written the prescription as, “Omeprazole Rx capsule 20mg.” I’ve been paying out of pocket since April, and it’s not even written in the Formulary the way they told me over the phone to have it prescribed. How could anyone possible know that. It comes down to who you talk to on the phone, and what mood they’re in. Geesh!

      2
      2 months ago Log in to Reply
      1. Lawrence S.

        A follow up. I got an email from the nurse at my doctor’s office telling me that she filled the prescription the correct way previously. Now, I’m negotiating between my doctor’s office and the insurance company to get a $%^&* prescription filled. OMG!

        2 months ago Log in to Reply
    16. Ms Cris

      I understand almost all the details. I’ve gotten really good at it to the point I threaten to send them a bill for my time to solve their issues.

      But, they always find a way to sneak in a surprise, don’t they?

      2
      2 months ago Log in to Reply
      1. Kayci Marr

        You’re hilarious! I love it!

        2 months ago Log in to Reply
    17. Kayci Marr

      I understand it and I also understand that insurance companies are practicing medicine without a medical degree 😔that we have to often explain what a CGM and pump is to someone who holds our life in their hands. America.

      1
      2 months ago Log in to Reply
    18. Babis Perantonakis

      In my country the Public Insurance covers 100% all services, products etc. for diabetics (Greece)

      2 months ago Log in to Reply

    How well do you understand the details of your health insurance coverage (e.g., which medications are covered, how much a service will cost, the steps you need to take about getting a service or product covered, etc.) Please select the number or statement that best represents your knowledge. Cancel reply

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