For meds and supplies I need to keep myself alive. I recently got divorced and my ex had wonderful insurance, I never had a problem getting anything and the costs were super low. Well now I have insurance through my job and it sucks. I just picked up a 1 one supply of insulin and had to pay $550.00 out of pocket. The pharmacy told me that the insurance company covered some of it. I started crying cause I can’t afford $550.00 right now, let alone every single month. What am I supposed to do? I can’t live without insulin, how can these insurance companies do this…Now I’m super scared to even try and fill my pump supplies, there going to tell me I owe a million dollars for them. I don’t know what to do, I’ve had diabetes for 25 years and a pump for 18 and I’ve never had to deal with this… so frustrated
I’m sorry to hear about your situation. I felt a huge sticker shock the first year of my diagnosis–so many tests, appointments, plus drugs. It did get better once I ht my deductible (& fewer appointments with time).
Does your employer offer a Flexible Spending Account (FSA)? If so, sign up–it will reduce your costs by 15-20%. Note that registering for FSA, I think, happens once a year. Pay attention to deadlines!
Good luck!
Before you get upset about this, carefully read up on your insurance deductibles, co-payments and limits. When just starting on a plan you will have not met your deductible. This is likely your current position. Once you reach your deductible you should then only have to pay your co-pay. If you have a high deductible plan you may have to pay out of pocket until you reach your deductible.
What is your deductible?
ps. You should also find out what your out of pocket maximum is. Once you reach that maximum you should be covered for 100% of covered expenses.
pps. With my insurance I can also save money by filling prescriptions via mail order for 90 days and only paying a single co-pay.
What appalls me is that the whole pricing structure throughout our health care “system” (for want of a better term) is predicated on the assumption that it’s an insurance company that is paying, and the prices providers can demand are inflated accordingly. So poorly insured individuals or ones with high deductibles get socked with prices only insurance companies can afford. Which is one thing if you’re just dealing with the occasional flu or sinus infection and quite another if you have a chronic disease like T1.
The other thing that is going on is companies are raising the deductables to keep the cost of insurance down. 2 years ago my deductible went from 500 to 2500. So the company can say hey your premiums haven’t been raised, but for those of us with a chronic condition it went through the roof.
You can contact your Endo or Diabetes center. Sometimes they have free samples to help out until your deductible is met.
Another option is to check your employer and review if there are other insurance options, particularly with a lower initial deductible, or prescription coverage that is separate from medical expense deductible. I had a PPO plan like that. May be too late to switch for this year, but you could choose another option for next year.
I would be curious if there are Cobra options in a case like this, and you could continue with the plan from your ex-husband, although premiums could be quite high.
This is my first comment I have made on this site and I will probably be asked to leave afterwards but here goes. I am on medicare with Health Net as a supplemental. I typically hit the medicare donut hole in June or July. So I look for better deals. One is, buy your insulin in Canada, Seven bottles of Lilly Humalog for less than $400 including shipping. Your insurance may not reimburse you but if you can get them to put the cost against your deductible it is worth it. As far as pump and/or CGM supplies, I have found that paying cash and being reimbursed is much cheaper. My CGM sensors list price is $473.00 but our wonderful insurance nightmare has negotiated that down to about $340.00. But when I pay cash I pay $160 for one months supply.
Most of Medtronics pump supplies are less expensive in cash than than through insurance and they will reimburse you
Hop the border to Canada :). Insulin doesn’t require a prescription in Canasa and it’s One-Fifth the cost compared to the U.S. because the Canadian government caps medicine prices. When you cross back over the border, if they see the insulin, just say you had it to begin with.
I don’t know. I have a high deductible plan too. Hopefully your deductible is not as high and you will hit it shortly. I pay 20% after I hit the deductible, which is still too much but better. I pay that until I hit the $6000 max out of pocket. Check your plan for the specifics.
Look for insulin savings cards. Check the websites of the insulins you use. I was getting $100 refunded for two years for each rx of Lantus (and Apidra when that was covered). Unfortunately, the Humalog freebie is no longer offered. Hopefully they’ll bring that back. If you can use the new variation of Humalog, there is a savings card for it. I have no experience with Novolog but might have savings available.
I use a very cheap meter and strips. The “preferred” one is $112/100 strips. The one I use until I hit the deductible is $18/100 strips. It’s accurate enough - about the same as the preferred one. I do not use a pump or cgm because I can’t afford it, but keep my A1Cs in the mid 5’s with pens and no scary lows.
In October, check if you qualify for subsidies for Obamacare or qualify for Medicaid in the state you live. If so, you can get better options starting in January, but do your homework to determine your best options.
I recently traveled overseas. Insulins were so much cheaper, but still more than most residents could afford where we were. The poor and working poor there die if dx with T1D - the average lifespan is 4 months. Humalog was $40 and Lantus $85 per box of pens - affordable compared to my cost of over $250, each. It would be cheaper to fly there, get a local clinic to write an rx, buy three months’ supply and fly home than buying it here! Too f’d up for words.
Good luck. Insurance should not be able to pull this crap.
you might find some help here
I’m in the same boat. I BEG my endo for insulin samples. I don’t care if it’s Humalog (my preference) Novolog or Apidra (I just don’t mix). I try to not throw away much insulin.
((hugs))
Quite a helpful comment–not sure why you think you’d be asked to leave. But we hope you’ll stick around!
Thanks for all the info
Thank you for all the info everyone. I looked into the home delivery and I can’t believe how much cheaper it is. I will never understand how the health care systems works but its really screwed up how they do things.
It’s a really cruddy solution, but if you get desperate enough and have a WalMart near you, they have their own “ReliOn” brands of insulin. Using them may mean not using your insulin pump, or having to make some SERIOUS changes to your pump settings, but they’re dirt cheap - but much older and not as convenient as modern insulins. They’re basically NPH and R insulins. R is much slower than Novolog, etc. I tried using a concentrated form of R I was using a Pump and it made meal bolusing a serious pain in the tuckus as it has at least a 45-60 minute lead time. The ReliOn R, though, costs about $25 per vial. It’s definitely an option of last resort, but its there if you have to take it.
If you’re particularly insulin-sensitive and find it worth it to do, you can get about 8-12U out of an “empty” pen of insulin by using a syringe and pulling from it like a vial. For some T1s that could be most of a day’s insulin!
Just wanna chime in that I’m totally in agreement with you. I think the cost of this disease overwhelms me and I have health insurance and a good job. I really wonder how I would feel if I didn’t…it is very expensive already and I’m in month 4 is all. Good Lord ! I feel blessed I live in a place where I can treat my disease so don’t want to seem ungrateful. It’s just sometimes when I think ahead on it (For e rest of my life) I get put out…
I dosed Regular insulin in an insulin pump for 9 years from 1987 to 1996. It’s not ideal but it is doable.
I do not PUMP but the following should still be helpful.
Check with your doctor, pharmacist or even the insulin manufacturer for COUPONs and/or PATIENT ASSIST.
Sanofi (maker of Lantus, Apidra, Toujeo, Afrezza) had and probably still has COUPON that allowed you to buy insulin for only a few out of pocket dollars IF you have insurance. They also offer free insulin with their Patient Assistance program for low income households.
If your doctor cannot intelligently discuss AFFORDABLE options, I would find another.
It’s also very helpful to build a stock pile of supplies in case anything were to happen. My old insurance paid a certain price for a month of insulin. I had my endo prescribe a vial more than I needed. I now have about 8 months worth of insulin.
The whole healthcare system is a scam in countries like the USA. Pharma companies keep a huge margin as it’s the insurance that’s going to pay. The real cost of production would be 1/100th of what they might be charging. Add some research and development costs to it. That’s the reason such industries should be highly regulated, which is opposite in the case of your country. It’s highly managed by the lobbyists. Both from the insurance and the pharma companies. In India one vial of insulin would cost less than 3 usd. The industry is highly regulated and there are severe caps on certain essential medicines, so that the patient dies not have to suffer. There is a lot more corruption in our country but in some cases the regulations are supportiveto the patients. Also none of the insured companies here would pay for diabetes meds. But who cares when we can get a months supply including testing strips for less than usd 50.
Get the insulin shipped from India if someone you know is coming from India to the states. That should be much cheaper. In my opinion it’s not at all unethical to do so because these pseudo governments should think about people like you before allowing pharma companies to rip us apart (by taking billions in bribe through some form or the other )
Sorry you are in this boat, it sucks 
Some things to consider that could help lower your cost, in no particular order
- Mail order. My copay to get from a pharmacy for a 30 day supply is about the same as a 90 day supply mail ordered.
- Your deductible. Have you met it? it could be the reason its so pricey.
- Your out of pocket max. Will you hit it, and when? After you hit it, you wont have to pay anything out of pocket for covered expenses.
- HSA or FSA? You can at least not pay taxes on the money for meds then.
- See if you qualify for different programs for assistance.
- Call your insurance and ask if there is anything you can do to lower your costs.
- Ask your endo if they can provide samples and explain why.
Hopefully this isn’t expensive as it appears at this time. Good luck.