I started a new job back in May and have been thinking the insurance is on par with my former insurance. I have just changed my mind as of Friday. Here’s the scoop on the new issue.
I have not been able to use my Dexcom G5 system since the transmitter died back in June. I got past my prescription deductible in the first month. The only benefit of sky high insulin prices. After that first $500 dollars things fell to $71 to $74 dollars twice a month for the one insulin and $35 for the other once a month insulin. That is not how often I take just how often I have to refill them. Test strip are only $15 every 2 weeks.
The Dexcom is a different beast altogether. Although you need a prescription to get it, it does not fall under the prescription plan. They call it a durable medical device. That moves it off the drug list and onto your medical insurance. Like a doctor visit or ER visit or like the rotator cuff surgery I will need next year after I’m qualified for FMLA (if we still have by then, Lord knows with the current administration’s hurry to get rid of all thing hurtful to corporations). So that means I have to meet the $750 deductible for the health side now.
The transmitters cost roughly $1000 each and they last for 3 months. The company I go through for them checked and came back with these amounts. The transmitter will run me $760. The $750 deductible and then $10 which is 20% of what is left over. The sensors for this are $528 a month so that will not even reach my deductible. If I wanted to get a 3 month supply to match the transmitter life I will end paying $928. That is with the $750 deductible cost added in. Last time I got a 3 month supply with former insurance it was $135 for both transmitter and 3 months of sensors.
What does this mean? It means until next year sometime I will not be able to afford getting these supplies. It looked great on paper to start with but the fine print will get you every time.
My old insurance was all pressed into one deductible. This one has 2 deductibles which total $1,1250. I’d like to get the universal insurance plan please. It comes out of the check as a tax so it does not get included on income tax. The biggest benefit is with a one payer system it is all or nothing for companies. Insulin has been at the top of the list for diabetics for many years as far as a large financial concern. There will be a price control on drug prices instead of letting them charge whatever they want. It is why diabetics are dying, the insulin they need to survive is just too expensive because of lack of controls.
Now there are those who have been touting the Walmart $25 insulin (NPH generic version of very old insulin) as the fix for those of us who can’t afford it. It is so old you don’t even need a prescription to get it. Sadly I talked with a guy on Facebook who gets this and it works great for him. He’s a type 2 diabetic who does not need short or rapid acting insulin. Type1 diabetics can not live without the shorter term insulins to bolus at meals and then the long acting insulin for background control. The one and only $25 insulin will not help us. We still need to get a prescription from our doctors (an office visit to pay for) and a much more expensive analog insulin which requires a prescription in all 50 states.
I make pretty good money at my job but house, gas to drive 75 miles a day to and from work, maintenance on said truck (yes truck that is 4 wheel drive for winter, it snows here), food and most of all the medical costs are still making it hard to do anything else.
Its just another frustrating day in the life a diabetic. My life is actually pretty good compared to others who are not as fortunate. It is just hat as soon as I think I am getting ahead I seem to fall farther behind. The meter is not a life threatening have to have device. I lived for many decades without and can do it again. It just makes life a little more sure and stable. I have had issues with lows and not being able to feel them until hey were too low. I liked being able to see at a glance if my sugar is right or not.
Brings up another issue from a while ago. I got into a discussion with a guy who felt that A1C should no longer be used as an average sugar level indicator. I’ll give it to him it is not a direct measure nor absolutely correct system. He was pushing for using CGM (Dexcom) data. It is much better at indicating blood sugar was his argument. My response it that it is neither a direct or accurate measure of sugar levels either. It does not measure blood sugar levels but intertissual fluid sugar levels which are “related” to blood sugar levels. He said the muscles are powered form the sugar levels in the intertissual fluid anyway. I gave up at that point as nothing I could find pointed in that direction. lol He kept telling me to Google it. I was. Neither way is a prefect measure of actual blood sugars and both have pluses and minuses. He had a chart that was supposed to show how CGM was so much better than A1C but would not reveal where he got it from.
CGM is nice but not needed. Only some have access to it and it is not much if any better than the older A1C tests done in every endo office I’ve been in. You do what you have to get the best control you can get.