Quick background: I have been type 1 diabetic since the age of 11. It will be 14 years this year. I am on MID and take Novorapid and Lantus. I use Abbott Freestyle Libre CGM. I am quite disciplined in terms of food and exercises.
I am going to move to the US in coming months and wanted to reach out to the community folks who could help me understand how I can navigate the healthcare system better to manage my type 1 diabetes
I have been hearing and reading a lot that the system is difficult to navigate from getting doctor’s appointment to handling insurance and prior authorization. Would love to know perspectives and get advice from folks who are managing it the best
Your experience will depend totally on your situation, i.e. whether you’re self-insured or have other insurance through your work that helps pay for doctors, drugs, etc. Without having that information, it’s very difficult to provide you information. The first thing is to find a doctor (Primary Care Provider or PCP) that deals with general medicine, or and Endocrinologist for specific diabetes treatment decisions, or possibly a Nurse Practitioner, or other health provider that will provide prescriptions for your meds. Getting an appointment with your provider may need to start now as it can sometimes take a significant amount of time to get one, anywhere from tomorrow to 2-3 months depending on the provider. These folks will need to accept whatever insurance you have and that’s a key point. Then you’ll need to find a pharmacy that also accepts your insurance and provide that information to your medical provider so they can send the prescriptions to the right place. Most providers use an electronic system to send prescriptions, but they may offer a hardcopy written script if that’s what you need. That’s probably enough to get you started. The meds you mention are pretty standard. Instead of Novorapid, here in the US its Novolog or the generic insulin aspart, the price points are likely very different and depend on your insurance, whether there’s a co-pay, etc. Lantus is available here as well, so that shouldn’t be different for you. Depending on where you’re coming from, be prepared for much higher costs; the US seems to pay much higher costs than the rest of the world, particularly for diabetes meds.
Good advice, TomH1. My only comment is that yesterday President Trump issued an executive order that all medications in the U.S. will be charged at the lowest worldwide rate. It will be heaven-sent as up to now the U.S. has been subsidizing medications for the entire world. We’ll have to wait and see…
Thank you for your reply. This is helpful - I am moving to build my startup and would not be on employer insurance. Any advice on getting a personal health insurance and finding a PCP or an endo? I will mostly be in SF
First, some questions like, do you have employment, what’s your employer, and what is their health care benefits like? I hope your employer provides great healthcare, otherwise, you’re in for some pain. It also depends on what state you’re in, as more affordable healthcare options are in New England and the upper Midwest. If you’re relocating to a major city like New York you can access some of the best doctors and hospitals in the country, and it might be a good idea to target those institutions for your care.
Immigrants are not eligible for Medicare; to be eligible for Medicare you have to be a “green card” holder as of next year. People on non-immigrant visas (“work visas” as they are generally termed in the rest of the world) never were eligible for Medicare, even though they paid Medicare! As of 2026 people on non-permanent immigrant visas are no longer eligible for Medicare.
For those who don’t understand the situation, i.e. not @Azeem, the situation for investors in the US is summarised here:
Generally, until the end of this year, issues like PTC and Medicare depended on the precise class of visa. Next year I believe it is more simple; no assistance with healthcare and, IRC, access to the insurance marketplace has ended (don’t quote me on that Hence my original comment.
What matters is the actual costs; it may seem ridiculous to go from somewhere where a Libre costs nothing, or a minimal amount, to a country where it costs close to $10,000/year but that is the reality for many people (not just immigrants) in the US. Although, as W told me on the video when I became a citizen, “We are all immigrants.”
It’s going to be a difficult learning experiment.
Know that you can always get NPH (long term) and R (short term) from Walmart pharmacy without a prescription. I think they will also sell you some syringes in an emergency. You can get a blood sugar machine and strips there, from the store shelf near the pharmacy.
Walmart will not exist in large cities. It is not open 24 hours. Have some emergency Walmart insulin and syringes on hand for when something goes wrong. Something WILL go wrong. When it does, no one will give you insulin. Know where the nearest Walmart is.
Where in the US will you be moving? San Francisco?
Your closest Walmart is a 30 minute drive, by car, if there is no traffic. CA has a lot of traffic. Its address is: Walmart, 1919 Davis St, San Leandro, CA 94577
To buy a private insurance policy will be very expensive. It will be even more expensive by the time you arrive. You buy that here: https://www.healthcare.gov/
This is where Americans sometimes buy mail order insulin from Canada. It is called Marks Marine Pharmacy. https://canshipmeds.com/
“I am a foreigner moving to California. I have heard some frightening things about the US healthcare system. Do you have any local support groups? Can you recommend any endocrinologists in the San Francisco area? Do you have any resources to help me?”
Hence my original comment.