Costs of Maintenance (Type 1)

I'm writing a few articles about pre-existing condition exclusions and health care coverage, and wanted to get your input on what the monthly expenses are.

For me (Type 2), it's $4 a month for Metformin, another $4 a month for lisinopril, and less than $10 a month for test strips. (I don't test regularly/daily, as my D is well controlled by diet and Met.)

What are you folks spending? What other costs have I missed?

Monthly Nail trimming at the podiatrists office $40.00/ Not covered by my insurance because they say its cosmetic.
Dental Cleaning every three months $95.00/ only two per year covered. I do the extra ones for safety
Foot Lotion cream monthly costs $10.00

Having just accumulated it for income tax, here it is:
Doctors and DDS, annual $285/12 = $24 a month
Prescription drugs annual $1561 = $130 a month
Supplies annual $374 = $31 a month
I have insurance + Medicare, I’m type 1, on Lantus and Humalog, test 7 x a day.
I don’t go to a podiatrist. No complications.
Good luck with the article.

My pump supplies ( cartriges, insets, and batteries) are covered by insurance 100%. I pay $20.00 copay for a month supply of insulin, $20.00copay for a month supply of test strips, and then there are lancets, sterilizing wipes, glucose tablets, back up insulin pen, ketones strips, and glucogen that need to be replenished as needed. I also try to go to the dentist for cleaning 3 times a year at about $100.00 a visit- I don’t have dental insurance. Then I have to take cholesterol meds because our numbers need to be lower then non- diabetics. I pay $10.00 a month for that.
I think that covers it for me.

When I was on insurance in the USA, my costs were:

insulin - $100 per month

insulin pump supplies - $150 per month (then insulin pump - $6000 every 4 years)
test strips for testing 10 times per day - $300 per month

Total: $6600 per year ($12600 every fourth year)

My insurance did not cover insulin at all and covered the rest of the supplies after I spent $2500 a year. So each year, my diabetes supplies cost me $3700 (plus insurance premiums of $2400 per year) and cost the insurance company $2900 + doctors visits, blood work, and … . But I had student insurance, which didn’t cover very much. I was diagnosed on the plan (so it wasn’t a pre-existing condition).

Things that my insurance covered with maximum a $10 copay:
Endo visit every three month - $180
Blood work every 3 months - ???
Hospitalization if needed

This makes me very unattractive for insurance companies.

I have type one, so it’s a little different.

$25/month for two bottles of Novolog. $25/month for three boxes of test strips (about 300 test strips). Pump supplies are covered completely under durable medical with this company. $25 for every doctor’s visit, and since I go to the endo every three months that would be $100 a year. More if you want to count the OBGYN, GP, eye doctor, dentist, and occasional foot doctor.

So most months I’m out $50 dollars for prescriptions, $75+ if there are doctor’s visits involved.

2 Vials of Insulin; $240 list, pay $10
200 Test Strips; $160 list; pay $10
5 sensors; $175 list, pay $21
10 Infusion Sets + 10 Res.; $180, pay $20

So each month costs $755, of which I pay $61.

That’s $9,060 a year, not cheap.

For whatever it’s worth, I’m in Ontario, Canada, T1 on a pump. For clarification, the provincial health plan does not cover prescriptions (except if medications vs income is considered hardship, but we won’t count that as it does not apply in my situation). However, the provincial government does cover insulin pumps for children and adults for T1s, which includes a monthly amount for supplies if T1 using insulin pumps. Anyone else requiring insulin pumps pay out of pocket. When I purchased my first one in 2003, it was through private health insurance (my employer). If I hadn’t had insurance, it would have been out of pocket, and I would have remained on MDI. The pump coverage for adults was implemented in Sept 2008.

Humalog (3 vials): $90
Infusion sets: $126
Cartridges: $41
Strips (avg 8/day): $130
Lithium batteries for pump: $10
Pharmacy fees (insulin and strips): $18
Lancets: $0 (ymmv lol)
Total: $415
Provincial allowance for pump supplies: ($200)
My cost: $215

This does not cover the assorted odds and ends, such as IV Prep, glucose tabs, and of course the occasional user errors such as accidentally catching infusion sets on door handles and ripping them out, bent canulas, wasted strips due to impatience & not getting enough blood on the strips,

If one is lucky enough to have private health insurance coverage through their employer (and I don’t unfortunately), that would go a long way to cover strips and insulin, so therefore one’s average net cost would be $37, which would be nothing to complain about certainly. But if one doesn’t have it, one can resort to some other programs, but for the most part, these programs are dependent on more long term unemployment situations.

How about I do it quarterly? $50 for insulin, $50 for test strips, $45 for a visit to the endo. $250 for my pump supplies, $50 for Symlin.

If it wasn’t for our insurance, we’d be broke just treating my diabetes. My insulin yestserday was allegedly $800

I added up all my costs, without insurance, late last year, it was a few cents under $10,000. That’s overwhelming. But I also forgot to add in batteries for my pump and meter and lancets.

From Pharmacy each month
$55 Apidra (3 vials)
$10 Test strips (300)
$10 for lancets if I pick them up (I mostly use Renew, which can’t be reused)
$10 Synthroid
$4 Lisinopril

So that’s $89 a month that I pay, and it’s about $600 that my insurance picks up… if I was on MDI it would be $35 more for Lantus, and my pen needles would be free (and insurance would be paying about $400 more)

Stuff that goes towards my $2500 deductible (it’s paid 100% after I reach that):
$150 in pump supplies per month
$275 for CGM sensors (though one box usually lasts about two months, as labeled that’s a “one month” supply).

Quarterly visits to the Endo are $50 each. I usually have at least one visit with my CDE in there as well… more if something is going on and I need follow-up care.
Eye doc is $50 a year

I don’t see a podiatrist because I don’t think it’s worth it… I have no feet issues, and after watching them treat my kid I’d have to be dragged kicking and screaming to see one…

$5 copays for opthmologist every 6 mo, podiatrist yearly, endo every three months, primary care monthly plus any sick visits so that’s about $100. Copays for Lantus, Humalog, test strips, lancets, $240 a years or more. Pen disposal containers $60 annually. Alcohol preps $20 annually. Ketone Stix $20 annually. Lost time from work if I exhaust my sick days $1500 annually. Plus all the covered costs like Insulin which would be $300/mo, test strips would be $150/mo lab work in the thousands, doctors in the thousands, other procedures (kidney ultrasound, holter monitor test, chest xray, and all those other lovely tests that MDs like to do ) would be in the thousands. Not to mention the restrictive diets we are all on and good food isn’t cheap!

When my son was first Dx’d with Type 1, he wasn’t on my comprehensive insurance but on his father’s catastrophic plan. That plan paid for 60% of the ER visit and associated fees, but after that, everything… and I mean EVERYTHING… was out-of-pocket. No prescription drug coverage or follow-up visits. I dropped $1200 at the pharmacy getting the full regimen of supplies when we brought him home; with freebies from the clinic and discounts, I brought that down to around $800/month - that covered test strips, 2 different forms of insulin, syringes, and strips for the blood ketone meter (a child his age can’t be tested using urine strips, which are cheaper). The meters themselves were given to me by the clinic, but had I paid for them, that would have been another $200 one-time cost. Because Eric was on diluted insulin, we also had free vials and saline from the clinic, and I don’t know how much those cost if you have to pay for them–maybe another $20/month? The difficulty with a little one like Eric is that he needs a fair bit more testing, and many more regular visits to his diabetes team. We were seeing the endocrinologist monthly, sometimes twice monthly, with out of pocket costs of anywhere from $160 to $240 depending on what tests were run and how much time we spent with which of the clinic’s professionals. And then there’s the Zofran - we have to keep an anti-emetic in liquid form on hand at home for when he gets those vomit bugs kids always get. That stuff’s expensive - couple hundred bucks for a bottle that lasts 2-4 months, depending.

So, in short, we were spending around a thousand a month out of pocket, and it would have been more if the clinic hadn’t been giving us supplies.

Once we got him on my insurance, with prescription drug coverage and coverage of maintenance visits to the endocrinologist, we saw a fair bit of relief on that score–particularly after we switched him to pump therapy and were able to get rid of the long-acting insulin. I’d say we’re spending about $40 out of pocket now per month on things like test strips and insulin copays, plus maybe another $20-30 on things like alcohol wipes, wipes to remove adhesive when we change pump sites, bandaids and antibacterial cream for treating finger sticks and/or pump site wounds, and juice boxes/chocolate milk boxes to treat lows (these are things I wouldn’t otherwise buy but they’re handy because they come pre-measured).

I shudder to think what’s going to happen to Eric if he can’t get insurance once he’s grown. I sometimes think I would do better to forget his college fund and put money away to act as his insurance fund!

I have very good insurance - I pay a co-pay for medications and insulin (Apidra)/Byetta - $20 a month for these, Glumetza - $35 a month, I have full DME coverage (through mailorder) for test strips (300 per month), lancets (Multiclix), and alcohol swabs as well as syringes and pen needles. I test 7-10 times a day as I am on MDI. Co-pays for endo - $20 each visit - about every 3 months. Covered fully for lab work, and hospital visits (full if in my health system I work at - co pays and deductbe are deferred, minimal deductible like $50 a day at other hospitals). Glucose tabs - not covered - $6-7 a bottle - a couple every couple of months. Same office co-oay for opthmologist.

I do have insurance through my employer. Including the portion of the premium that I pay (pre-tax, automatically withheld from my paycheck,) I expect to spend about $2800 this year. This also includes doctors appointments, pump supplies, and Rx’s. I don’t use a CGMS and don’t see the podiatrist. I have my teeth cleaned every six months. Last year I spent about $2500.

Pauly, keep this in mind when you reach Medicare age they will pay for your foot care every 2 months.

i just got insurance so now i pay 9 dollars for two bottles of levemir, 22 dollars for my preferred test strips (i love my wavesense, you can’t take it away from me) for 100 test strips(go through about 200 a month, so 44 dollars) (which i have a sneaking suspicion i could make my doc prescribe more…not sure yet), and i get 3 month supplies for my other medicine, which would equal 30 dollars. I pay about 16 dollars for a box of needles, unless the price has gone up… and i have no idea about my humalog yet…my doc appointments and blood tests are free, thankgod for tricare
here’s a interesting calculator you might like to check out:

I’m T1 on injections. I pay $180 per month for insurance from my employer.
Out of pocket includes:

My portion of insurance premiums through employer @ $180 per month= $ 2160
Insulin @ $50 per month= 600
Oral meds for blood pressure, thyroid, depressioin, cholesterol
and depression @ $150 per month =1800
Test strips - no copay for up to 5 per day. I test 8 times per day so supplement
with the cheaper ones from Target. 90 strips @ 50 cents apiece= $540
Syringes - completely covered
Voluntary OTC supplements off aspirin, omega 3’s and Coenzyme Q @ $50 per month =600
2 eye exams per year @ $30 =120
4 pcp visits per year @30 =120
4 shrink visits per year @ $30 =120
1 visit per mnonth with the health psychologist @$20 =240

So, that’s a little over $6000 per year on my part. (Ick - that was hard to see in print…)

Honestly even though my expenses are more than your rent, I still consider myself lucky. Mostly because I have insurance coverage, and we’re not paying a dime for it (it’s taken care of 100% by my husband’s employer). I’ve been in a place where we had to pay out of pocket for insulin, test strips, and all supplies, and that’s not a nice place to be… at all.

So even though I complain that our deductible is so high, and I pay so much in co-pays, I am thankful to have the coverage I have… because it’s the assurance that if something bad happens, we’re taken care of. I hated feeling so insecure when I was first diagnosed, and uninsured… it was scary.

i just got insurance, and i’m so happy because now i can actually go to the doc without having to scramble for money. Now alot of the companies have programs to help people that can’t afford their medicine, i got free insulin through lilly cares and sanofi aventis when i didn’t have insurance. Now i know test strips have some help… but the cheapest on the market is the wavesense 16.49 at walmart for 50 strips. Hurray!