Recently, as I have been facing transition between insurance plans I have been a few weeks without insurance hoping I could avoid getting on Cobra while still not loosing continuity of insurance (ah… the joys of our health system in the US… :D) I ended up signing up for Cobra, which I will be on for only one month. But the experience of being without coverage all of May and June was truly remarkable: Novolog vials @ more than $100, crossing my fingers to not have to go to the doctor or piling up appointments before they were due (as much as possible) to try to get them in while I was still covered… you get the picture.
I can only imagine how life must be like for those out there (20% or so of all Americans) who are uninsured or who are going through a period of not having a job now, with the economic slump the US is going through.
Just wanted to put this topic out there for those of you affected by these times, so you could vent a bit and share what you do to cope with the lack of a job or the lack of insurance.
So my whole life with diabetes has been about trying to make sure that I have enough supplies to get by… with insurance in the USA, my deductible was SO big that I only bought supplies every other year. And I bought enough in one year to last me for two. (Tricky I know.) My insurance company didn’t seem to notice… or at least I always got by.
For me, the biggest concern about gaps in insurance is that diabetes becomes a “pre-existing condition” for your new insurance. I think then the new insurance is not required to fund anything diabetes related for a year.
Manny, will you have diabetes coverage as soon as your new plan starts?? I hope so!!
I am in a transition time now too, though not in the US system, but I am still not sure about how to get my supplies a month or two from now. Soon I will be 100% in the Hungarian national system and I will be able to worry less…
I think the stress of insecurity in the US system can do serious damage to one’s blood sugar!
My husband,who at one time was unemployed.He doesn’t have any prescribed meds so it is just me that requires medical insurance.The test strips are 100$ for 1 box of 100.For a person that takes their blood sugar 5x a day it can get quite expensive.My mom(bless her heart) would give me test strips of theirs, beings that my parents are both Type 2s.It truly is a blessing to have family.Had it not been for family my health would have suffered.
My coverage: I have been lucky in the sense that my parents’ insurance with Aetna covered me to the age of 25 and then their COBRA covered me to 28 (thank you, TX law). In my line of work (private voice teacher), I’m a self-employed contractor and can’t get insurance. Tried applying privately several times. Letter always came back stating they wouldn’t cover a diabetic - even with no prior lapse in coverage. Joined a music teachers association that offered benefits. The insurance guy actually laughed at me (not in a mean-spirited way) and said “not a chance. sorry.”
Marrying into insurance: My husband is a contractor, but with benefits through a contract company. We got married at the j.o.p. the week before my 28th birthday (and five months before our planned wedding) just so I could get on his insurance (how romantic! laughs). Since then, we’ve been covered under three different insurance plans, each with new rules and new deductibles. We lapsed for only 30 days and my endo cut her bill almost in half so I could be seen. I am amazed at how much doctors TRY to work with you. My podiatrist yesterday told me that it’s best with insurance to expect nothing, because that’s what you’re going to get.
Strips: I agree with everyone on strips. I’m supposed to test 8-10x a day right now between pump therapy and pre-conception planning. That’s 300 strips a month. 6 boxes of 50. My pharmacy doesn’t even keep 6 boxes in stock at a time, but with auto-refill, their computer orders it for me. With one insurance plan we were on for about 7 months, I had to pay out-of-pocket for two months while I resolved the issue of BCBS of Michigan considering test strips to be durable medical and not pharmaceutical, so I couldn’t get them locally. (BCBSM also didn’t cover diabetes education visits but once a year and with certain restrictions.) Now I’m with Anthem BCBS (based in Virginia). Test strips are covered, but only 200 of them a month. I now have to go through pre-authorization where I try to convince Anthem that testing more than 5-6 times a day is actually good for me. The same companies that tell us that the CGMS is no more effective than finger-sticking put limits on HOW OFTEN you can check your BG?! It’s a crazy mixed-up world.
Questions: I feel fortunate that my mom worked for United Healthcare for 8 years and my mother-in-law works with insurance at a hospice company. I have lots of people I can ask questions of. I think it’s a crime that we aren’t taught how this system works. Where was the class in high school that taught you how to review benefits packages, start a retirement fund, and do your taxes? I feel sorry for people who struggle with these complex life issues with no easy answers.
My hubby and I got married under the same circumstances! I was changing jobs, and going to be between insurance plans. We had recently bought a house so finances made COBRA prohibitive. We had only started making wedding plans, and weren’t even officially engaged. While my engagement ring was at the jewelers being set, we went to Vegas and got married. Six months later we had our big reception complete with a fake wedding. He “proposed” once we were back from Vegas. Still kind of bums me out that I didn’t get a real proposal, but in the end, going to Vegas just so I wouldn’t be without health insurance was even more heart-felt and romantic. Plus, I wasn’t all that nervous when we got married in front of our friends and family since we were already married.
Hello my name is Dino. I’m single and I enjoy romantic dinners and long walks on the beach. I’m looking for someone that would like to include me on her health insurance policy and would like to get married as early as tomorrow. Please respond and I will make arrangements to meet at the Chapel-O-Love in Las Vegas. Drinks are on me.
…some of my frustrations with health insurance are documented in my blog.
Oh the survival game can be so rough on us.
Wow, I thought I was the only one who “married” for insurance. Well, let me re-phrase - got married EARLIER to get coverage.
I am currently trying to outlast a 90 waiting period for benefits at my current job and am withouth insurance. My doctor gave me about 4 bottles each of Humalog and Lantus (THANK YOU) so I am ok on that. Syringes - I end up resuing sometimes, though they are relatively cheap at Wal-Mart and other pharmacies here in Dallas.
Now strips - oh the racket! Basically, $1.00 per strip ( I have a OneTouch meter). I am supposed to test at least 6 times a day and WANT to - but it’s expensive and my doc can’t help me on those.
It’s kinda depressing - I had to stop using my Animas pump because I can’t afford the supplies right now. But, I know my insurance is coming, so I am just trying to stay well until I am allowed to get sick.
There is a document (it’s a pdf file-- you need Adobe Reader to view it) that lists options for getting reduced-price or free diabetes supplies. You can view it here.
I really feel for those of you out there without health insurance, but just from my own experience, I am not sure that national health care for the US is the right answer.
My husband is active duty and we are on the military system, which works similar to what I presume a National Health Care system would work. Yes, our coverage is a benefit of his service and is at no cost (definitely not FREE, as we give up a lot for his service), but the care has not even been slightly comparable to what I received in the civilian world. If you are a Type II, they are more used to dealing with that (lots of retirees with Type II) and more likely to have an answer for your issues. Many times, I feel like they just don’t know what to do with me, a Type I on a pump. I do not have an endocrinologist (just the “diabetes specialist” at the clinic). He’s a smart guy, but not an endocrinologist - and he sends me to a Diabetes Nurse Educator for pump help. The old DNE we had was GREAT, but her husband got transferred, and the new DNE seems to be more on-line with working with Type II’s. When I was pregnant, nobody but OB would work with me - not the folks you want helping with your pump calibrations. They put me into DKA in the hospital by not giving me insulin (after taking my pump away) while admitted for pregnancy complications. The list goes on and on. At least with commercial health care, there are more choices. I am grateful for what we have, and I feel like most of the docs do the best they can to help me, but I feel like I am definitely not always getting the best care out there.
If we could find a system that would work and still provide top-quality care, that would really make a difference.
As a reservist wife… I pay a co-pay when he is activated. When he is not activated… I don’t have any insurance at all. As a type2; my doctor tells me it is my fault that I am diabetic. yeah, right. with unemployment
we can afford to not eat flour based foods in our household. VENT. My veggie/fruit low-carb meals are dont exist and I’m more hungry/thirsty all of the time. My numbers/stress etc in life are high anyway.
“sarcastic laugh” my husband activates in a couple of weeks to go to Afghanistan so I can have ins while he “serves” Unfortunately, we cannot afford the copays due to him being unemployed since last summer and we have debts to pay. When the money comes in; I’ll pay bills and get new shoes for the kids. There wont be any money for test strips of much of anything else. I’ve cut the light pole expense ( we live rural out here) I’ve cut directv and will cut cell phone as soon as he deploys. There’s nothing else to cut from our bills (I homeschool and have to keep the internet as it is part of our requirements to have:) I can still come here! LOL!)
I’ve been skipping meals… it doesnt even lower my bloodsugar number when I do that. Somehow, I’m not even losing weight. sigh…
Although I’m currently on a very generous insurance plan (thanks to my husband’s wonderful company), it was really hard for me to get supplies in college. I had insurance coverage through the school (it was the UC system) and I had a wonderful doctor there. But, each time I go to the pharmacy, the main pharmacy lady always gave me a hard time about testing. I was instructed to test 4 times a day but can only get 100 strips to last 30 days! (It scares me that these pharmacists can’t seem to count 4 x 30 is 120!!). One time I asked for an extra vial of insulin because I was visiting family in Indonesia for a month and I always have back up (in case the bottle breaks, who knows what can happen when we travel) and she grilled me on the spot! UUUUGH. Thankfully, the pharmacy assistant was really nice and I prefer dealing with him from then on.
I was in such a habit of reusing syringes and lancets for soo long, now that I have good insurance, I still can’t get out of the mindset that tomorrow, I might not have the supplies I need. It sucks that here I was, in college, trying to take care of myself, and can’t because I don’t have the $200 to spare for extra strips or bottle of insulin My husband has been great because just a month ago, I finally stepped up and asked my doctor to prescribe me 300 strips! That’ll last me longer than a month, definitely and I only ask for refills when I really need them (usually down to the last two bottles of strips).
I hope the Cobra system will help you. I knew an old friend who was diagnosed with T2 and had to be on Cobra after she left school. She was struggling a lot with the sugar levels and with other problems as well!
I’m sort of naive about how all this works … I’ve been healthy most of my life and haven’t had to navigate medical systems much (haven’t had insurance much either). I was lucky to still have insurance under my ex-partner’s plan when I was diagnosed, but am now transitioning, waiting out a 90 day period for insurance to kick in at my job.
When people talk about being denied for a pre-existing condition, isn’t that primarily for individual insurance? or do i need to be coming up with a plan b?
In other words, when my 90 day waiting period is up, what are the chances that I’ll be denied?
Your new insurance will probably have some sort of clause that states that they will not cover any meds or treatment for your diabetes for a specified period of time (like 6mos, a year, whatever - at their discretion) because your condition “pre-existed” their coverage of you. If you did not experience a “lapse” in coverage prior to their insuring you, they will waive this hold time.
I administered health benefits for three companies for over 20 years. So I have some expirence. Here is my favorite story it involves a retired police officer. The deal with the plan was that if a person was married at the time of spousal death the plan continued to pay for the life of the spouse. So the former police officer is over 70 and passing from this earth. He married a 17 year old and died the next day. So long as she does not get remarried she has 99% paid health insurance for the rest of her life.
Now here is the funny thing, six months later she gets remarried. Ain’t love grand.
Melissa is correct.on the prex. That is why Manny took the COBRA benefit, being without insurance, even a one month break in coverage can cause the new plan to require prex waiting periods. It is important to not drop coverage but to try everything you can to bridge coverage to a new plan so you can get a certificate of coverage.
I currently don’t have any insurance and haven’t had since 2005. I am trying to get Social Security and Medicaid, both of which I have doctor’s signing off on and one helping me with a caseworker because I was already denied once. Right now I have a lot of medical bills stacking up. My doctors work to get generic drugs for me as much as possible. Though Humalog insulin is a little bit expensive but I have Lily’s Patient Assistance program.
Due to medical conditions other than my diabetes, I’m not able to work out of the house. I’m trying to get my graphic design/web design business going but its is going pretty slow. My husband is the only one working and the insurance that he is offered isn’t worth it for the price that he would pay adding me on. Though we also know that we wouldn’t be able to put me on it because Utah has high risk insurance for those that have conditions like diabetes and bipolar disorder. For the cheapest high risk insurance pool, it is around $300 a month starting out. The best is almost $600. Not like we can afford that right now. That’s why we are hoping for the social security or medicaid to come through.
If anyone has any other ideas they would be greatly appreciated. That’s what we are doing so far. And also going to lower cost clinics and as many generics as possible.
We were already married.
My husband has been great because just a month ago, I finally stepped up and asked my doctor to prescribe me 300 strips! That’ll last me longer than a month, definitely and I only ask for refills when I really need them (usually down to the last two bottles of strips).