I’m hoping to get information on best plans for those with type 1 diabetes on insulin pumps and CGMSs. My husband is now eligible for health insurance and there are a ton of plans for Federal employees. I’m at a loss of which to even call for more information. Anyone out there on the pump and cgms and can recommend a plan to research? Would greatly appreciate any and all advice. I’ve heard BCBS standard is a favorite - but it also holds the highest cost. Any others that are favored?
I’m on the Aetna federal CDDF plan (I think it’s CDDF - it’s consumer-driven deductible something). I’ve got low premiums, but a higher deductible - I find that doesn’t really matter b/c I’m going to spend more than just about any federal plan’s deductible in a year anyway. I got approved for a Minimed pump 3 months after diagnosis, didn’t have to show any blood sugar records. I then got approved for the Minimed CGM a year later (didn’t try to get one before that), and again, no blood sugar logs needed. I switched to the Omnipod, which they didn’t pay for b/c it was only 2 years after my first pump. But they cover the quarterly supplies. I just got the Dexcom and they cover that, too. Everything pump- and CGM-related is covered under DME at 90% and prescriptions are $10 co-pay for generic and $20-$40 co-pay for higher level tier brands. I’ve had no problems whatsoever, and would highly recommend it.
Oh, and I’m single so I have no idea what the costs are for a family plan.
Are you on the Fed BCBS standard or basic? Yes, I really want the standard plan, but don’t think we can justify the cost if we can get similar coverage at $170/month less.
i am on BCBS Basic, which seemed best, before i got diagnosed (t2) but i have been having a hassle getting my meter and test strips. i am only 2 months in, so maybe it will work out. Just my observations.
Hi I was just wondering what decision you ended up making. I am a type I and have been on the standard plan for seven years and have had no problem getting cgm supplies or pump supplies. I was just wondering what plan you ended up going with? If you went with the basic how is that?
I went with APWU (American Postal Worker’s Union) which is run by Cigna. So far I love it! They’ve covered, without question, EVERYTHING (except my 10 or 20%) including an MRI. Yesterday I found out that I can use medco (www.medco.com) to order prescriptions online and they’ll fill 90 day supplies that way. Plus, according to my calculations, the difference in cost between medco and cvs is $1200 - in my favor - per year. This is for my diabetes medications, humalog, and test strips as well as another prescription for my Rheumatoid Arthritis. Additionally, I’ve not yet found any doctor’s office that doesn’t accept it.
So yes, while I’ve heard BCBS premium is the best - I think APWU is pretty excellent for the difference in cost.
I have been on Federal BCBS since 1998 and was on bc most of my career before that. I have the standard. When I worked, I only had to pay 10% for the pump. Now I am on Medicare and BC as secondary and have no co-pay at all.
Yes, it costs the most. But my calculations showed that it paid the most for me and all the meds and pump supplies, etc. I am now paying the full amount for both in retirement and still think I come out even at least in terms of my meds, pump, supplies, and so on. We have an expensive disease.
Compare what they pay. You have all the materials online to do that. And remember, you can change the next November if you feel you made a mistake.
Same for me I just got my new pump and cgm three months ago. I am considering the switch to basic I just do not want to get caught with high copays or bing declined for my animus pump supplies, dexcom supplies, and humalog. Is dexcom and animus in network? I am assuming they are not tyical RXs. I guess like you say I can try it this year and switch back next. I have only had my cgm for 3 months now but would be lost without it.
i stayed with BCBS Basic… i did some checking, even though the copays on my strips are higher than i like the total package was pretty reasonable.
My husband is a Federal Employee and I'm switching to his health insurance from my State health insurance. He doesn't have any chronic illnesses, but I'm Type 1. I have a Dexcom and plan to start pumping in a couple of months.
After reviewing the 2012 benefits, has anyone changed their opinions on the best Fed health plans for Type 1s who wear a Dex and a pump?
I saw your note and yes, I'm still very happy with APWU. They've covered 90% of my everything - diabetes, rheumatoid arthritis and more. Plus, I just heard that if you do a diabetic-specific program with them where you just call to check in every now and then, they'll cover 100%. I haven't called to start the program yet, but if you do contact them - ask about it.
Thanks for the response. We signed up with APWU high. Good to know that you're still happy with APWU.
Was googling for this very topic and saw this thread. I too am a Federal employee and I've been on APWU high for the past 2 years. I joined the diabetes management program they have and for the most part, I'm extremely pleased. They cover 100% of all my meds (currently on apidra, lantus, and using lipitor). Part of joining the program required me to start using medco to have my prescriptions filled. I was a bit reluctant at first because the thought of having insulin mailed to me is a bit scary but so far so good (one shipment so far. They packed it really nicely with ice packs and the bottles/pens were still cold when I opened up the package). All of my supplies are covered 100% as well (test strips, lancets, pen needles, syringes, the meter itself)
The only thing you have to remember is you have to speak with one of their "nurses" every 90 days. They told me that if I call on the 91st day, I'll be kicked out of the program. So I setup a reminder to call every 75 days (just to be safe) on my phone.