I recently switched jobs (and entered the “real world”- first time I haven’t been on my parents insurance) and seem to have it pretty good. I was just wondering about other peoples experiences.
For me I have a $25 co-pay when I see the doctor, I do not pay for any kind of testing (ie labword, thyroid uptakes etc.), they cover my pump supplies and pump (omni pod) at 100%, I pay $50 for 3 months (8 bottles) of insulin, and $10 for 3 months of test strips (600). I take meds for graves disease and a 3 months supply of that is $5. In my plan they say they will cover the CGM if I have more than 6 lows (below 40) a month or am planning/are pregnant. My doctor thinks I should go ahead and get it but I haven’t decided yet. Anyways, thats just me- wondering what other people are paying.
Wish I had your insurance.
My wife and I pay 100% of everything until we meet our family deductible of $3,000. 1 physical per year for both of us is paid for by the insurance and not included in the family deductible. After that we still pay 20% until we have, I believe it is $5,000 out of pocket between us.
Of course we do qualify for a Health Savings Account, due to this definitely qualifying as a high deductible plan, so that does help. We are able to sock a good amount into that each year. For 2008 we can put in $2,900 each. That can be used to pay medical bills not covered by insurance and can be carried over as long as we don’t use it. Can even use that in retirement to pay for nursing home, sheltered care, etc.
Ours is similar to yours, Victoria.
On my husband’s insurance, they cover DME (durable medical equipment) at 90%, so I still had to cover $600 for my last pump (luckily, could trade in the old one for a $500 credit toward that!). Co-pays are $20 for doctor’s visits (lowest I’ve ever had). For my Rx’s, I pay $30 a month for 2 bottles of Apidra short-acting insulin and $72.40 a month for 400 Freestyle strips, but I use a discount card for my strips that knocks $50 off that every month. They’ll cover my CGMS because I could prove I was below 40 six or more times per month or they would cover it for a confirmed pregnancy (not pre-conception - tried that and they said no).
This is much better than my last plan earlier this year. Doctor visit co-pays were twice that and they wouldn’t cover my diabetes educator at all - had to be an annual program done only at approved hospitals!
I can’t get insurance through my own job because I’m a self-employed contractor working for school districts as a private music teacher. And I can’t get private insurance because of the big D word. I’ve been denied several times. I do, however, have an option to enroll in my state’s health risk pool if my husband’s insurance ever drops us for some reason.
Mine, through my husband, is about the same and from what I’ve had before it is WONDERFUL. Mine pays 100% for durable medical equipment which means pump, pump supplies, etc. I have a $50 copay for a 90-day supply of name brand drugs (insulin and test strips). I have a $25 copay for a 90-day supply of generics, which I have none of at this time. I have not checked on the CGM yet, but I assume it is considered durable medical equipment as well, but I’m not sure. I will be checking into it soon probably. I have a $20 copay for doctor’s visits and any other visit that is not incorporated with my doc visit like CDE or dietician, etc. Insurance pays 100% for labwork, etc. I just had a baby in July and paid my copay of $20 for my first doc visit and then insurance paid 100% after that, hospital and everything. I love my insurance right now and I hope my husband keeps this job for a very long time because of that.