Hello,
With opportunity to have a 3-years job in US, I want to know what is the circuit for treating my Type-1 diabete. I am French and work in France.
I need a hand, should I visit a medecin Doctor or directly a specialist.
Can I bring insulin for the first month and could I easily find in US Apidra or Lantus Insulin ? Can I buy easily freestyle sensor ?
Thanks for feedback
Regards,
Julien
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Yes, you can bring insulin with you. Any doctor in the US can prescribe insulin and there is some insulin that you can buy directly over the counter without a doctor’s prescription.
I use Apidra as well. It is not as popular as Humalog (Lilly) or Novolog (Novo Nordisk) but it is widely available. It requires a prescription. Regular insulin can be purchased over the counter at Walmart. Lantus is also widely available and you should have no trouble securing it in the US but will need and Rx.
Endocrinologists are the doctors that specialize in hormone issues and follow people with diabetes. Due to a shortage of these doctors, it can take 3-6 months’ wait for your first appointment. Primary care doctors can see people with diabetes but some of them don’t feel competent to manage insulin in a patient.
Abbot’s Freestyle Libre sensors are also widely available but also need an Rx here. You should bring some extras with you to tide you over until you can get situated with a doctor.
@FrenchLeuk, Julien, You probably should get a primary care physician (GP) right away and have them refer you to an endocrinologist for your diabetes care. There is no problem obtaining Apidra and Lantus from US Pharmacies and the FreeStyle Libre constant glucose monitors. All will require prescriptions by your new doctor(s).
I hope that your new employment includes a good private health insurance, because the out of pocket price for insulin and sensors is outrageously high in the US.
As to transporting insulin from France to the US, the best I can offer is this link.
https://www.diabetes.org/resources/know-your-rights/what-can-i-bring-with-me-on-plane
Perhaps some of our members who are more experienced in international travel can give you more information.
Good luck and may you enjoy all 3 years of your stay.
One other thing, try to get your medical history in a digital form, and sad to say, in English as we Americans are definitely ignorant in other languages. If you were coming to College Station, TX I would recommend PCP Sybil Taquet , MD who is originally from France. She would not need your records in English.
Insulin requires a prescription here so try to find a doctor to prescribe refills right away.
Also if you don’t have health insurance insulin is very very expensive here. If you need discounts this is a good starting place https://getinsulin.org
That website tracks all the discount programs insulin makers offer.
CGM (freestyle) requires prescription also. Primary care doctors are not always up for prescribing those because they don’t want to do the “Prior Auth” paperwork. A diabetes doctor would be more likely to do that for you.
If you can I would attempt to bring more than 1 month’s worth of insulin to allow you time to see a doctor.
You might be able to go to an Urgent Care and get a prescription if your supply is running low but I don’t know anyone who’s tried that before.
Sadly in the US its not as easy to get insulin as you might be used to. Please be cautious and start working on it as soon as you can.
Once you have a doctor/insurance its not an issue.
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Check how good the health insurance is. Some employers may lack decent coverage and gaps. You also need your pre-existing illnesses covered. It’s a different ball game to France.
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One important note is that a foreign prescription is not valid in the US and many foreigners do not understand that. I have Global offices and staff periodically come to our US office and have with them a prescription they need to be filled, which requires my company to first find them a doctor that can see them on a moment’s notice and then write the prescription.
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Thanks everyone for answers.
Rx is, I guess, Prescription Terry4 ? Perfect to find same Insulin(s).
I don’t think French Prescription is enough, so I will probably contact first a Doctor.
I prefer now CGM (freestyle) so I will follow what you said ChrisP
I have already talked about Health Insurance and it is one condition that finalize my decision. jack16
This is famous in Europe and France that US Insulin price is very much more expensive that Europe.
I am aware that cost of Health is more expensive in US and I cannot explain why Insulin is much more expensive. We pay closely the same price of our “NIKE” shoes in France than US. So this is strange that everywhere in the rest of the world Insulin has a mean price…
I’ll try to bring my last results and try to contact the Doctor you recommend me @Luis3 .
I was writing this note when I see your post CJ114 So I probably need the prescription for the plane travel.
Merci
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Yeah, Rx = prescription. Sorry for the undefined acronym!
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Most of this is covered already by everyone else, but let me add a few things.
I assume you are working for a large company, in which case you will have good insurance.
If you can get an endocrinologist as your primary care doctor, then do that. Depending on where you will live it might be a difficult task to find one.
I’m not sure prescriptions will not be accepted from France.
I was able to get insulin in Germany and Spain with my US prescription. I don’t see why you couldn’t get your French script filled if you need it.
Your first order of business is find a doctor who will prescribe your insulin.
You will need a prescription for Libre too.
But maybe you want to move to dexcom because they are better sensors
Welcome to the US and your new job!
Bon Chance!
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You will not need your prescription for plane travel. It will not be valid in the US, but you will be allowed to bring a reasonable supply from France if you wish. I have never been asked for a prescription when I come into the US, even when I bring in several month of insulin.
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I am sure your prescription will not be accepted in the US. I have that issue with my foreign staff from all countries, even for cold medicine that is OTC the pharmacist needs to see US license to purchase if that medication can be used to make another prohibited product.
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Hopefully we’re not making it sound to stressful, just want you to be prepared for the differences in how you get care.
If you were low on supply I would go to a pharmacy or urgent care or emergency room and someone should at least know how to get you some more insulin quickly. At the minimum someone in those places will hopefully know how to get you a prescription and refill quickly even if they need to make some calls.
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A few thoughts about doctors.
If you are working in a major city, that increases your chance of finding a good endocrinologist. Also, if you are in a major city, some have hospitals that score highly for diabetic care. I trust US News Health to compare hospital departments for endocrinology, and to a lesser degree look up doctors.
You can Google doctors to see how they rate on various platforms, and although you should be wary, it pays to stick with doctors that are highly rated by a large number of patients. Depending on your medical plan, you might need to limit your choices to those that are in your health care plan, but still, choose the best you can.
Curious, what city are you working/living in?
This is the link for looking up hospitals, Best Hospitals for Diabetes | Rankings & Ratings | US News Best Hospitals.
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First: I would recommend traveling to the US with at least several months worth of insulin especially if it’s analog (not just R or N) insulin and you are not prepared to go on R+N after your analog travel supplies run out. (Spoken by the guy who won’t even fly a domestic flight for a 2-day trip without taking several months worth of insulin, at least a month in two separate bags, in addition to whatever I can carry in my pocket.)
(Maybe folks outside the US never had to build up their own stockpile so are unfamiliar with the concept.)
In many/most urban areas you are looking at a wait time of several months to get an endo appointment. Many PCP docs unwilling to prescribe insulin (not that PCPs are easy to get an appointment at either). If you first need a referral from a PCP to even get an endo appointment (common with many insurance plans), urgent care clinics might be a good start and may be more willing than a regular PCP to write prescriptions for analog insulins on the spot if you show up with a foreign prescription. Prescriptions for CGM are even more specialized and usually require insurance pre-authorizations which few PCP’s will be able to do but most endo practices can handle.
And as a reference to what is available OTC in what state, this is only a little out of date: https://childrenwithdiabetes.com/insulin/prescription-laws-and-resources/
A couple states recently passed laws allowing diabetics to get emergency analog insulin refills after a prescription has run out but AFAIK a foreign prescription won’t help here.
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Hello @JamesIgoe
It will be Dallas
Hello @Tim12
What is PCP ?
What do you mean R or N ?
Thanks everyone
PCP - Primary Care Physician
In case “Primary Care” isn’t a common term that is the regular general doctor you see. Then depending on your situation they may offer treatment or refer you to a specialist. Some types of US health insurance require you see the PCP before being allowed to see a specialist.
R or N refers to old Human insulin. You can get that without prescriptions but I think most people consider that substandard care. To get a modern Analog insulin you have to have a prescription
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CGM is my freestyle sensor. This is not automatically prescribed by the doctor. Even if I want to pay it without any insurance ?
How much does it cost ?
CGM requires prescription. I don’t know the prices of Freestyle but Dexcom is about $100 per-sensor (every 10 days). Also $130 per-transmitter (every 90 days)
So sought estimate no insurance would be $450 per-month.
I don’t personally know anyone who pays that. My insurance covers it 100% but I’m sure there are many with less or no coverage for CGM
Without insurance I believe a single insulin pen is around $125. Most people with insurance likely don’t pay that price.