You're not covered any more

@Thas, your persistence (and connections) served you well. The system should not require such tenacity and luck. Glad to read you got the CGM covered. I think it’s terrible that people with T2D are looked at askance when they seek CGM coverage. CGM use saves more money than it costs. Think of the expense of just one 911 call!

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I felt a bit sheepish writing about my short 30-minute bout of fear and uncertainty when I know many of people with diabetes struggle with this all day, every day. My glimpse into that realm was a lot more harsh when it personally involve me!

Managing insurance coverage is tough. It’s a job that I struggle with, too, but I am getting a little better with it as the years go by. I can remember times when I got worked up just working my way through the computer phone maze just trying to get through to a human being. I just kept telling the voice recognition software, representative, representative, representative! The computer would finally get that I wanted a human to talk to and my blood pressure was through the roof. I’ve finally learned to calmly work my way through that. It’s obviously simple but took me some time to remain calm.

Good luck with your insurance call, Marie. I hope you get a good night’s sleep soon!

it’s 2:15 pm here and ive been otp almost all day trying to straighten this out. currently waiting for a representative to pick up. it’s stressing to say the least and the only good thing is ive lost my appetite.

“your call is important to us…”

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I hope it went well, Marie.

I know that every time I have to speak with CareMark, I have to work very hard to maintain my composure. The thought of calling automatically raises my blood pressure.

Oh yeah, the “your call is important to us” dance is maddening. It is important because one of their metrics is “call abandonment”. If it is too high, they look bad to upper management, so they do lots of things to keep you on hold.

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I’m not sure. we used to have good insurance, but the past few years have been a real nightmare.

I think I spent well over 30 hours researching, being on the phone, going downtown for a one hour appointment with a so-called Medicare enrollment specialist (NOT!!!), to enroll in 3 items: Medicare Part B (that required me to go to the SS office twice, and for my wife to drive to another city to obtain a signature from her HR person on a form that SS had given to me), a Medigap policy, and a drug plan. Talking with representatives who don’t always know their business well, and/or can’t explain things properly made the process both difficult and time-consuming. Frustrating doesnt even begin to define how I felt over the course of a couple of weeks of decision making, and enrolling, which is a VERY SLOW PROCESS.

It took so long on the phone that I had to do it using Google Hangouts so as not to exceed my monthly minutes with Verizon (700 a month–I have unlimited data, which means I’ll always have limited talk minutes). Sometimes Hangouts disconnects, which is a pain when the person to whom you are speaking can’t call back, so you have to start the process all over again with someone else.

What alarms me about these stories is how do older seniors who might have trouble getting around and / or keeping these things all stait possibly deal with so much BS?

I wondered the same thing the entire time I dealt with asking a million questions of Social Security employees, as well as numerous reps from two insurance companies. I ended up with AARP. Because it took so long to sort it all out (lots of note taking), I can’t begin to imagine how difficult it would be for someone less understanding of all the ins and outs.

@Sam19, @phoenixbound - Our health care system in the US is needlessly complicated and that very complication works to the benefit of powerful and monied interests. Older seniors really need a health care advocate to assist them to negotiate with the health care system. Lucky older seniors benefit when a smart and motivated family member or close younger friend fills that role.

For many, however, their interests fall through the cracks and their needs are not met. I can only hope that someone’s there for me when I’m old, frail, and maybe demented and an ill-informed medico administers the wrong or inappropriate insulin dose. Yikes!

i lived in a chinese country (taiwan) for 7 years where i was exposed to a culture where taking care of elders is sacred. i didn’t buy into it 100% because i don’t believe in sacrificing for family who have treated you poorly, but it opened my eyes that i needed to be more considerate of my mother, who was a saint. during the last 13 years of her life, i was happy to have her live with my family in an addition to our home that she personally designed, over saw the construction of, and paid for herself. she always wanted to be an architect. anyway, i was also happy that i was there when the cancer doctor prescribed pain medicine that must have interacted with another medicine she was taking, or was just too strong. she almost choked on her drool. once she had so much anxiety from some medication she was taking that i had to sleep in her room with her all night to calm her. lots of stories like that. it sort of burned out my circuits with all the crises that came along. we took care of her in my house with hospice during her last week as well. i told my husband that if i am in that situation, make sure he puts my hearing aid in and turns on some nice music even though i am unresponsive. also, hospice/the hospital never told us to give her basal in her last days. she was totally insulin dependent. i have since read that if you are insulin dependent and not eating in your final days, you still need basal to have a comfortable as possible passing. so much we didn’t know, but we tried out best so i am at peace.

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I friend of mine has a welcome mat outside their apartment door that says that. “Please remain standing on the mat until the next available resident can open the door!”

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Very true, Terry. Kaiser started attuning their coverage to Medicare’s at least 6 years ago to my knowledge. Test strip numbers impacted me directly. Other things, as I shifted into Medicare with Sr advantage are good. My strips cost me nothing and my doc is great about making sure I have enough. My lab work-ups are also no-cost. Specialist co-pays are only 10 bucks…Of course, I feel that this could change at any time. Gods forbid right wingers take over congress and the white house—they hate all of us who are “weak”…

Oh my, Marie. Of course I covet that “welcome mat”— but you know that I wish I was there to hug you while you have had to go thru all this…I’m ahead on strips again, so let me know if I can send you some…xx000…Judith

DrBB—I mixed up posts and replies–but as I posted below to Marie—I covet that “welcome mat”…

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Wow! I’m glad you were able to clear it up so quckly @Terry4! I think that BG monitoring and correcting BG should become the central focus for advocacy. This is a constant sword of Damocles that hangs over us and it comes up again and again but there’s no medical basis it’s all costs. Well, sorry you have to pay for it but ■■■■ you, you don’t have diabetes ■■■■■■■■■■■■.

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Thanks for the comment, @acidrock23. I know there are limits to society’s resources but it’s so clear to me that keeping BGs relatively normal with a high percentage time in range is the cheapest way, in the long run, to manage diabetes.

Unfortunately, I think the bean counters keep a short horizon and don’t make the same connection that we make from everyday BGs to the long term consequences. Avoiding kidney dialysis, for example, is a huge savings versus test strips. Economists, however, have a hard time measuring avoided long-term complications.

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I think our central advocacy should instead be to bring costs down so that we don’t have to depend on insurance as much for our on-going expenses. Just think, if the average diabetic Joe could comfortably afford as many test strips and as much insulin as they need / want, heck maybe even a pump and supplies— we wouldn’t be subject to the whims of a corporate insurance agency. I think if we can ever reach that point it’ll be true victory.

Insurances companies get rich by rationing our supplies and creating hurdles between us and our needs. If only we could afford what we need without them-- only one way to get to that point-- reduced costs.

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Not that I want to get embroiled in some kind of political debate here, but this post does underscore one of the realities of living in the United States, with it’s institutionalized system of inequality in the area of healthcare, and Canada, which thanks to a visionary called Tommy Douglas has enjoyed the benefits of universal health care for all it’s residents for the past half century or so.
Sure there are many here in Canada who complain that although they are rich they end up getting the same health care options as someone on welfare. And yes, wait times for elective surgeries like hip replacements can sometimes be long because everyone gets the same treatment options in this country.
However, in most provinces medical coverage is free for all residents and includes all visits to doctors and specialists, lab tests, hospital care, diabetic supplies like insulin, pumps and strips and hospital care whether it is emergency care or other surgery or treatment. In the provinces where it is not free, like here in British Columbia, I get all of the above for a monthly fee of less than $100. .
Yes I know there are those in the US who will mumble and grumble about the dangers of socialist medicine like in Canada, but besides the points above about equal wait times and equal treatment for the wealthy and the poor, there is little to grumble about when you actually live here. And for those who think otherwise, the trip across the border to a private US clinic is short, just bring a credit card with a high limit on it.

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Well it’s not all roses and sunshine over there. As a type 2 diabetic I wouldn’t even be cnsidered for an insulin pump. I know because I have friends having trouble getting treated in Canada for a myriad of diabetic complications. My treatment of my diabetes in the United States has been far better than what she received.

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