Prescription Advice/Insurance

Good morning all,

I currently live in the UK and am looking to move to the USA to the New Hampshire area with my Fiance who is american. I have type 2 diabetes and was diagnosed 6yrs ago aged 26.

I currently use Novomix 30 Flexpen to inject. Here in the UK prescription for people with diabetes are free but I was wondering if anyone was able to tell me how much the pens would be in the area I am hoping to make my home?

Also how does the medical/health insurance work? does this cover you for your medication costs or would I not get insurance for my pre-existing condition?

Any advice would be appreciated.

Many thanks


Well I’m not american, but my hubby is (though he’s now immigrated to canada) we had the talk about me moving down to be with him but with me being diabetic the cost of independent insurance was not going to happen (he called around and couldn’t get a company that would even insure me - growls) and getting me added onto his existing one though possible again because of the D it wouldn’t have been covered - which wasn’t great but it was how it was.

Not sure how it is where you will be moving but we chose for my hubby to move up to canada because of our universal health care (might not cover the cost of drugs, but at least one doesn’t have to pay for seeing a doc or specialist), and those he can’t get independent health coverage do to his pre-existing medical condition the cost of his med is a lot less (he was pay close to 200 for a 3 month supple, same drug here 20 bucks for 3 month supply).

You should have your FH look into medical coverage for you, before you get married and everything so you don’t have to many surprises along the way if at all possible - since immigration into the US can be its own nightmare (then again so can immigration into the UK or Canada).

Strange, I’m Canadian, Type 1 diabetic…and my drug costs are covered under the BC Pharmacare plan. I pay $1000 for supplies each year, at the beginning, and then I get 100% coverage for the rest of the year…which is $5000 in pump supplies covered! My mother is also a a Type 1 and receives the same coverage. We are both in low-income bracket so I’m sure that makes a difference, but I know even up to middle bracket you should receive somewhere around 70% prescription coverage.

I know we do pay a premium for the BC MSP (doctor services) plan. It’s somewhere around $50 a month. If you get the MSP coverage, you automatically receive pharmacare for prescriptions as well.

I too have an American fiance, and he is currently facing some problems coming to Canada. He recently moved from Iowa to Bellingham WA to be closer to me (I am in Vancouver). So I came up with a solution; since I want to go into a healthcare field and will qualify for student loan forgiveness later on, I am going to attend the university in his new town to get my Bachelors degree. As a student, I can keep my MSP/Pharmacare running and simply hop the border to pick up my supplies. I was already accepted to the University and am just working on getting my loans going now, fingers crossed that they come in time. While I am at school we are going to work on getting him into Canada, which will include us getting married at some point this year, I hope. It all comes down to money, a problem since our relatives are far apart and all want to attend, lol… >,>

Thank you to you both for kindly replying.

I am just so confused by it all. We are trying to work out of we can afford all my medication or whether to just live here in the UK.


Once you get married, you would probably be best off in the U.S. if you are covered on your husband’s insurance which I assume he will get where he works (I know, these days, that is only an assumption!). If you tried to get insurance independent of an employer it would be VERY expensive, and you could definitely run into the “pre-existing condition” issue. I don’t know what the rules are for non-citizens, that would certainly interfere in getting something like Medicaid, but probably not insurance. I would check those rules out to be sure, perhaps with the consulate personnel? So, the best option is to get married and be placed on his insurance which would have a monthly premium but far more reasonable than indpendently aquired insurance.

As far as what it covers, that is very varied based on the type of insurance. If you get on with an HMO such as Kaiser, most services are free, and medications are very reasonable (like $10 or $25 for 90 days). I have a PPO and pretty good coverage. My meds are the same as above, though I have one med and my strips that are $75 for 90 days. But I have a $20 copay for doctor visits. Everything else, tests, labs, pump supplies, etc I pay 20% (after I’ve met my $500 a year deductable.) Many people have a larger deductable, and couples do as well. I’m actually switching to Kaiser at the end of the year. I’m sure this post has confused you more! The U.S. is not the best place for healthcare, that’s why President Obama is trying to reform it. (Disclaimer: not meant to start a healthcare reform debate!)

Thanks Zoe, it doesn’t take much to confuse me lol

My fiance does work but he has his own business.

I think I best do some more research…

Oh, I see, it sounds like your fiance is currently living and working in the U.S… If he has his own business, does he buy insurance? If so, then he could check with his insurance company about what it costs to put you on the policy. (Again, this would be predicated on your being married). He could also discretely inquire about their policy regarding physical exams and pre-existing conditions. It’s harder when you have individual insurance than when you have group insurance through an employer. I also don’t know if you plan on working here (or even if you legally can!) If so, then getting insurance through your employer might be an option. Employer provided insurance doesn’t check for pre-existing conditions, they have to accept you, privately purchased insurance doesn’t have to accept you.

I don’t know what his opportunities would be for work in the UK, but if they are equal, it definitely would be something to consider.

Hi Zoe,

I don’t know if i’m getting things mixed up, if I purchase insurance does this then cover the medication costs or is it just if I need medical attention?

My gut reaction is to be cynical and say, “Stay in the UK.” If your future husband is employed and is fortunate enough to get insurance through his job (no guarantee here), you could get covered under his plan once you are officially married, but not before then.

What is covered under his plan (or any plan) depends on the elements of the plan itself. Some plans have very generous prescription drug coverage and some do not. What he can do is call his insurance company and find out what they would cover. They should be able to tell him this over the phone.

In terms of pre-existing conditions, the Affordable Care Act that was recently passed here will eventually make it illegal to deny coverage because of a pre-existing condition. But for now, health insurance companies (I believe) can still deny coverage. But this usually only applies to private policies (i.e., not the ones you get through your employer) and very small companies. If your future husband works for a large company and has a decent plan, you should be fine once the two of you are married.

In the event that your future husband does not have health insurance through his job, once you are married, you can then go through the process of becoming a U.S. citizen (which takes about 2-3 years I believe). Anyway, only then can you apply for something like Medicaid or be covered under your state’s high-risk insurance pool that was set up to help people with chronic conditions (like diabetes) who are unable to get private plans.

Unfortunately, at this time, health insurance is tied to where you work in the U.S. It’s a HUGE problem. I just saw below that your fiance` has his own business…does he buy his own insurance? How many people does he employee? There are just so many variables that would affect your ability to get covered.

If I were in your position, I would consider two options. Option #1 - Staying in the UK and seeing if he could move there. That way, you stay under the NHS. Option #2 - Move to the U.S, but stock up on all your meds and insulin beforehand. Make sure you have plenty of supplies. You might be able to keep your enrollment within the NHS and go back periodically for check-ups and to get more supplies. I know people who have done that. It’s not impossible. In the event you get really sick and need emergency care, emergency rooms cannot turn you away. Also, many states have clinics and some free services, especially for people with diabetes. You can look into that where you’re moving to and see if there’s anything available in your state.

Finally, if you really must move here, consider looking into various free/subsidized programs through eli lilly and other companies that make D supplies. I think there is a list here on TuDiabetes somewhere that lists the phone numbers of those companies. Call around. They may not even ask about your immigration status and may just inquire as to whether you have insurance or not.

Thank you, you have all given me something to think about. Sounds like it’s not going to be straightforward whichever way I choose. I just want to gather all the info so I can make an informed decision. I will discuss with Fiance tonight and see what plan he has through his business.

I really want to move to the US but it looks like it’s going to be at a price.

No, most insurance plans have some form of payment provision for doctor visits, prescriptions, tests, treatments, hospitalization, etc. What varies widely is what percentage of those things it covers. (And how much deductable you have to pay first. A deductable is an amount you have to pay full cost of things before the insurance coverage kicks in. Mine is $500 which is very good. The deductable doesn’t apply to doctor visits (which for me are always $20) or medications.

HMO’s are large “Health Maintenance Organizations” (Kaiser is the most well known) where all your services are provided in one place. They are generally the cheapest in terms of premiums but more important in terms of coverage. Meds are low cost and other things are all free. PPO’s are Preferred Provider Organizations. They have a (large) list of doctors and hospitals that are part of their “network” and you can pick whoever you want. They are rarely 100% coverage like the HMO’s.