Costs for insulin, pump etc

Do you have to pay for the insulin, pump, suppliements…? Is there any difference if you have insurance or not?

Here in Sweden everyone is guaranteed medical help, you pay the medical visits up to about 100€ per year. The insulin and the diabetic equipment are so far free. I think it is really interesting to know how it works in other countries.

Hi Maria, it sounds a lot simpler for you! Here in Ohio, with my plan I pay the following:

Pump: Medtronic MiniMed 722 = $6000; (-$1,200) for in-network discount between Medtronic and my insurance co.; (-$2,500) for my Durable Medical Equipment benefit which, luckily, I hadn’t used any money from this year = $2,300 out-of-pocket for the pump. $51.69 a month for four years under the payment plan plus $3 installment fee per payment.

Test Strips = $10 for 200 OneTouch test strips

Insulin = $30 for 2 vials which last about a month with my pump

Pump Supplies = $100 for 3 months of supplies. Falls under major medical coverage and is subject to 80% coverage.

Dr. visits = $20 co-pay

Labwork = $0 covered under my plan

Being a member of = Priceless! (just felt right to add) :slight_smile:

That is pretty much all of it. The rest is out-of-pocket.

I live in Hungary and the government insurance pays for 85% of all costs associated with insulin pumps. Insulin is covered 100%, as are most prescriptions.

The only part that I find annoying is that they only cover enough test strips for me to test 5 times per day! So I have to buy a lot of strips at full price, but they are still cheaper than strips in the USA. The meter is from a Hungarian company called Elektronic 77.

I have lived with diabetes in the USA-- and I didn’t have very good insurance. So it cost me about $3,000 per year plus the monthly insurance payment.

Yes, systems are different.

lol… i like that punch line there mike…! being a member of tuDiabetes = Priceless!!!

looks like you have a pretty good coverage … what insurance company are you in?
how much is your deductible? mine i only get the 80 percent coverage from my insurance when i met the thousand dollar deductible…but so far so good …

i couldnt believe you only have 100 dollar out of pocket expenses for a 3 month supplies…

just a quick question though, how many boxes of test strips do you use for 3 months? i just started ordering in bulk, like a 3 month supply, i ordered 12 boxes of test strips… this is yet to be proven if it will be enough for 3 months…also, i ordered 3 boxes of infusion sets and 4 boxes of reservoirs…

like i said, this may not be enough, this is my first time to order in bulk…

Most Americans with health insurance pay their monthly health insurance premiums (which vary depending on your job, age, health history, and size of family) and their insurance has different amounts of money they will spend on durable medical equipment and pharmacy supplies. Before American health insurance companies will pay a percentage of your medical bills, you must pay an out-of-pocket deductible, which varies depending on your insurance. For instance, I had a very low deductible this year and had to pay $200 out of my own pocket before my insurance benefits kicked in. It means that your first medical bills beyond regular doctor visits are usually your responsibility to pay for each year. Once that deductible is met, the insurance kicks in.

Most people get their pumps and supplies paid under “durable medical equipment” (which with my particular insurance, for instance, the insurance will pay 90% and I pay 10% of the final bill, so my $6,000 pump cost me $600) and the insulin and strips through “pharmacy” where you often have a set limit you can buy per month and you pay some sort of set co-pay amount (for instance, I pay $50 for each high priced prescription I fill, $30 for mid-range drugs, and $10 for generic). My strips and insulin happen to be higher-price drugs, so I pay the higher amount. There are cheaper strips I could get, but I like the brand I use. There are set quantity limits for most drugs each month. I have to fight or pay out of my own pocket if I want more strips per month. My endocrinologist had to write a letter and make several phone calls to get my insurance to pay for their portion of the 400 strips I use each month.

It’s a very complicated system here in the States, and it varies with each insurance company and with each insurance plan they offer their customers and with what your particular employer has agreed to when they partner with that insurance company. If you are a senior citizen or are not working and seek out our Medicare system, there are even more hurdles to jump. And if you change jobs, everything changes, too. For instance, my husband had one insurance with his last job that ended in April. We were without insurance in May while we waited the mandatory waiting period before he could elect coverage in the new position. We started with the new job’s insurance in June, and then in July, his employer changed their agreement and partnered with a new insurance, so we switched companies again. The amount of paperwork we have had to file in four months is enormous and it’s hard once you switch insurance to get the old insurance to agree to pay for what they said they’d pay for. It’s a tough system, to be sure. And I am obviously no fan of it.

My costs sound a lot like Melissa’s. I paid about $550 for my pump eighteen months ago (I had already met my yearly deductible), and supplies for the pump are 90% covered once I reached it ($300 deductible per person with my husband’s insurance). I pay $35 once every three months for nine bottles of insulin, ditto for 900 test strips. Whatever you need for one month, they just multiply it by three and charge you either $10 for generics or $35 for “brand-name” drugs (this is their mail order program - retail pharmacies are something like 50% covered). My endo visits are $30 and, until recently, the labwork was covered 50% until I met my deductible, no cost (I think) after. I’ve been bad about reordering supplies and getting endo visits done this year - chalk it up to a major move in May - so I’m about 5 months overdue for one. Part of the issue is I have to find a new endo first :confused:
The main difference between different insurance plans is the amount you pay per month, called a premium. This varies a heck of a lot between people as it’s based on risk and number of people covered by the insurance plan. Particularly for more than two people, it gets crazy expensive. Before my younger brother was eligible for Medicaid because of his disabilities, my folks were paying somewhere between $700 and $850 per month with higher co-pays and deductibles. This is AFTER I got off their plan and took the insurance available through school (50% DME coverage, could only get prescriptions through the school pharmacy, astronomical deductible).

In Canada all doctors visits are free and so are A1C’s. As of September in Ontario, the government will cover the cost of pumps and supplies as long as you are followed by an endo. As for costs of MDI, you need to have insurance coverage to cover the costs. I am 100% covered here at work for prescriptions and in the process of putting thru my pump.

If you have to pay for supplies it runs as such:
test strips/100 $99
Insulin $20-30
Syringes $40
These are all rough numbers, it’s been awhile since I had to pay out of pocket.