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.