Hi every one !!
Please let me know if your Insurance company covers your expends in T1D ( insulyn, pump, CBGM, doctor assistance when traveling other countries, etc…) and also If you are satisfy with them.
Should WE raise our voice ?
Its every thing OK regarding insurance coverage for T1D people ?
Its a private insurance bussines issue or should the Goverment or ourself as a TEAM help ?
What do you thing ???
The issue is that in spite of the demands placed on patients with diabetes to manage their condition intensively, many insurance companies place unrealistic “cost-savings” initiatives which might actually prevent that from occurring. For example, United Healthcare, the nation’s largest healthcare provider, previously placed a somewhat arbitrary limit on the number of blood glucose test strips they would cover … with my previous healthcare plan, that was limited to 6 per day. However, most patients (particularly those using insulin) need to test before and after each meal, which is by itself, 6 tests per day, plus anytime they get behind the wheel of an automobile, so for the average person, that is 8 times per day (going to and from work), plus perhaps once before bed, or anytime a suspected hypo has occurred. That is easily a minimum of 10 strips daily. My doctor had to get “pre-authorization” for any amount over 6 times per day, which seemed like just harassment and unnecessary bureaucracy to me, but it was some bean counters’ idea of a good way to reign in costs (neglecting the waste elsewhere in their plan), neglecting that the very essence of good glycemic control is dependent upon regular and frequent testing. Today, I have a different healthcare plan (my company switched providers) who does not have these restrictions on testing, but it seems like many do!
My health insurance is good when it comes to covering diabetes supplies. Insulin (all brands) & test strips (no limit) are covered at $10 co-pay each prescription/month. Pump & supplies (including CGMS) covered 100%.
I can’t complain, $10-$20 co-pays depending on what I need. Everything for the pump is covered under my major medical benefit. I only pay 10%, however if I reach 2.5 million in a year then I have to pay out-of-pocket. All but $2000 was covered of my pump, I had saved up some money so it wasn’t bad there. I’m not sure if my coverage would be better or worse under a universal health care plan in the US.
I have no coverage. I worked for a very small company with a very greedy boss. The boss changed my sales compensation plan so he could have all the profits and pay me no commission on a sales transaction. My attorney advised me to not return and later sue. What neither of us realized? No COBRA for companies under 20 employees and no unemployment approved. A lethal break in heath care coverage has booted me out of the system, three years into my T1 diagnosis. I am now 38 and have a lot of uncovered, diabetes care in front of me.
My former boss leaked throughout our local industry my T1 condition. I’ve since been untouchable because no one wants their overall coverage costs to go up and seen non-competitive among their other employees. So I started my own business to have a chance at making a better life for myself…
As far as healthcare coverage goes… owning my own business turns out to be a bad move. It seems I would be rewarded with healthcare coverage if I had no drive, ambition, etc. and just starting living off the welfare system.
I’ve tried so many routes to get covered. In the state of Ohio, if you look at the underwriting table for T1s (which an insurance friend finally showed me after months of frustration) the only result listed is “DENIED” across the board. No age or condition or lifestyle considerations.
I put a lot of time into my community and the world around me. Sometimes it is hard not to be bitter that my contributions to the world are met with “Sorry… not profitable… you deserve to die a horrible, painful, slow death.”
My survival has come to rely on the kindness of others. Sometimes I have to choose to live without heat in the winter or electricity in order to afford my insulin and test strips. I wait for months and endless hours to attend the free clinic (which is overloaded with patients) and I haven’t seen an Endo in years because I can’t afford it.
There HAS to be a better way…
I have no complaints Tricare is pretty good! It may take a while to get what I need but that is ok, I will bug them until I get.
You live right around the corner from me. Let me know what I can do to help, I would be more that happy to get some supplies your way. I just switched to the pump and have 4 Humalog pens in the fridge. If you want them, they are yours! The extra caps for them as well! Pens are a pain in the ■■■ to fill a pump with. I have a new perscription for vials anyway. What sort of meter do you have?
Desiree,
I spent the first 10 years with Type 1 with no insurance. I was diagnosed at age 19 and had aged off my father’s insurance. It’s bad. You also happen to live in one of the few states that don’t require health insurance companies to offer coverage for diabetes treatment & supplies so even if you do get insurance, things still may not be covered.
I have more meters than years! 
Actually, a friend just took over managing costs for an insurance company (ironic) and he found that the True Track system has the lowest operating cost over time and a side kick tester. However, most recently I’ve been using the One Touch Ultra Mini, but my favorite was the small Free Style (however, I dumped it because the test strips are so expensive.)
I also use vials of Novolog and Lantus. I like the convenience and resilience of the pens, but it seems the vials are cheaper and I can draw a 1/2 u if needed, and I always seem to be on the edge of needing that extra little 1/2 u.
Thank you so much for your offer… your a sweetie!
My Insurance in Venezuela its not bat. Ritgh now Iam on my firts steps to see if they cover my CGM or a PUMP. Iam looky because the compamy insurance cover my expenditures on T1 ( Ia.m in shots since 33 years ago ). I have no confirmation yet from the company but Iam working on it.
If you as a T1D try to get coverage as a individual most of the companies dont cover anithing regarding T1 or put yoy on hold for at least 24 months… If you try to get coverage by the goverment, its dificult to receive humalog or new medications they just offer very few and old ones… Its sat very frustarting… I pass with no coverage around 15 years and all the money have to came from my poket before that…
In Caracas geting a minimet pump cost locally around 22 million (bolivars) and if you add the supplyies for a year catteteres and CBG sensor you go up to 35millions (around 12.000 to 15.000 US$) If the local insurance does not cover me, probably I have to go up to FL and buy one there ( should be cheaper… ) I hope… Any doctor recomendations ? Thanks all for your recomendations…
I have medical coverage through Canada’s universal medicare system - absolutely no complaints there.
I have coverage for my 80% prescriptions and diabetes supplies (including pump supplies) through my work.
Anything not covered by that plan is covered by my local govt’s chronic disease program with a $250. annual deductable. If I didn’t have prescription and supplies covered by insurance at work, it would all be covered by the chronic disease program. The CDP paid for my first pump. I pay for any upgrades. My CGMS upgrade cost me $700. and the transmitter $500.
From what I have learned from others on this site who live in countries with Universal healthcare, it sounds as if you most likely would not be wearing your pump if that was your coverage, unless you paid it all yourself.
That is what I thought. Which is why I probably lean more anti-Universal health care. BBBUUUTTT, then there are people like Desiree below that could truly benefit from it.
Rock - Me - Hard Place
I am not a type 1, but am a type 1,5. I have both Medicare and BC/BS. Neither have given me any trouble for the costs of my syringes, lancets, test strips or insulin. Strangely enough the biggest expense i have is for the insulin itself But I only pay $29 per vial and i don’t think that is bad at all. And the company for my meter has offered me a new meter free, but has cautioned me to be sure to check about which test strips are the most economical (cheapest) because they don’t want to pay more for test strips than they do now. Funny isn’t it?
Yes in deed they do - at least 90% - Thank God!
I live in Italy with universal health care and pay nothing for prescriptions, bloodtests, and any doctor’s visits related to diabetes (eye doctor, endo, etc.). In the U.S. I was on my parents’ insurance and in Wisconsin the law is that all diabetic supplies must be covered 100% by insurance with no copays - that included an insulin pump, all pump supplies, insulin, test strips, etc.
WTF! Limit test strips, let’s take a step back to my ignorant call outs. Some insurance companies blow my mind. It’s like standing someone in the street and saying we really want you to stay well and healthy and happy so you don’t cost us any money but you’re only aloud to look up for cars 5 times a day. The math is simple, more tests = better diabetes control = less long-term complications, bottom line.
Sami, start looking for some individual plans now. Usually you can find a decent plan through someplace like Blue Cross and woudl still be cheaper than COBRA or not having any. You don’t want to have a lapse or they will murder you with costs to get reinstated. Even when you find a job you may have to wait up to a year for them to cover you if your insurance lapses. They will consider it a pre-existing condition. Just some food for thought.
Wow, I think I’m moving to Wisconsin!
Hi Kirsten, what is universal health care its public? private? who can any one acces to it ?