Can You Manage Diabetes Well Without Lots of Money?

If you live in a country like the United States, where the majority of health insurance is privatized and there is no strong social safety net, it can feel as though managing a chronic disease like diabetes requires nothing but lots of money. And it does. As of 2017, diabetes cost the United States a staggering $327 billion dollars per year on direct health care costs, and people with diabetes average 2.3x higher health care costs per year than people living without the disease.

Diabetes is also devastatingly expensive personally: the cost of insulin has risen over 1200% in the past few decades, with no change to the chemical formula. In 1996, when Eli Lilly’s Humalog was first released, the price for a vial of insulin was $21. In 2019, that same vial costs around $275. Studies show that 1 in 4 people ration insulin simply due to cost. Diabetes Daily recently conducted a survey study, with almost 2,000 participants, of which an overwhelming 44% reported  struggling to afford their insulin.

So where does this leave patients who don’t have tons of money to spend on insulin and supplies, or who don’t have adequate health insurance coverage for the technology to help prevent complications? Can you manage diabetes well without lots of money? The short answer is yes. The long answer is a bit more complicated.

Best Practices for Managing with Less

If you have insurance coverage, but are unable to afford a continuous glucose monitor (CGM) or insulin pump, it’s advisable to follow best practices for optimal diabetes management. According to the Mayo Clinic, one should test their blood sugar:

  • Upon waking
  • Before meals and snacks
  • Before and after exercise
  • Before bed
  • More often during illness
  • More often when traveling or changing a daily routine
  • More often if on a new medication

One study has even shown that following a lower carbohydrate diet can improve health outcomes, reduce complications, and cut down on medication costs for people living with diabetes.

The study goes on to say that, “…insulin dependent diabetics can expect to half or third their insulin requirements. Less insulin injected results in more predictable blood sugars and less hypoglycemia.” However, no patient should ever feel pressured to follow a low carbohydrate diet solely to control the cost of their medications. There can be more effective ways to manage the cost of medications and supplies.

Photo credit: Adobe Stock

No Matter What You Think, Get Coverage

People with diabetes need health insurance coverage. In the short term, this makes sense, as insulin and things like insulin pumps, continuous glucose monitors, syringes, and test strips are expensive. But it also makes sense long term as well. People with diabetes can face serious complications as they age: diabetes is the leading cause of adult blindness and amputations, and is a leading cause of stroke, kidney failure, heart disease and premature death in its sufferers. Having health insurance helps pay for things like surgery, preventive screenings, doctors’ appointments and follow-up care, and any additional medicine and needs that’s needed.

It may seem cheaper to forego coverage, but don’t. Check to see if you’re eligible for Medicaid in your state. If you are, this comprehensive coverage will help you access affordable medication, doctors’ visits, emergency and preventive care. If Medicaid is not an option, see if you qualify for a tax subsidy on the federal or your state’s health exchange. There, you can find a range of affordable options that will cover your diabetes care and (especially) insulin prescriptions.

Get Help Paying for Insulin

Even if you have health insurance coverage, the cost of your insulin may be prohibitively high. According to the CDC, between 2007 and 2017, the percentage of adults aged 18-64 enrolled in a high deductible health plan rose from 10.6% to 24.5%. These plans have a high dollar amount that consumers must meet before their plan kicks in to help pay for things like prescriptions or hospital stays. Some high deductible health plans have deductibles as high as $10,000. This means that someone with diabetes could potentially pay the full $275 a vial for their insulin, every time they fill their prescription, until they reach their $10,000 deductible. These types of plans are cheaper monthly (have lower premiums), but don’t offer great coverage.

If you need help paying for your insulin, you can get low cost insulin through these assistance programs:

  • Eli Lilly’s $35 Co-Pay Program: Launched in early April in response to the COVID-19 crisis, Eli Lilly is introducing their Lilly Insulin Value Program, which allows anyone with commercial insurance and anyone without insurance to fill their monthly prescriptions of insulin for $35.
  • Novo Nordisk: Novo Nordisk has recently launched a $99 program, where people needing insulin assistance can purchase up to three vials or two packs of FlexPen®/FlexTouch®/Penfill® pens or any combination of insulins from Novo Nordisk Inc. for $99.
  • Sanofi: Launched in 2019, Sanofi’s program allows people living with diabetes in the United States to pay $99 for their Sanofi insulins (with a valid prescription), for up to 10 boxes of pens and/or 10 mL vials per month.
  • Medicare: Medicare recently unveiled a pilot program that would cap the cost of insulin. The Medicare Part D Senior Savings Model would cap insulin co-payments to $35 per month, starting in January 2021. Seniors must sign up for a plan that will qualify under the pilot during the open enrollment period, which is October 15 through December 7.
  • Buy a State-Regulated Health Plan: If you live in Colorado ($100 per prescription per month), Illinois ($100 per 30 day supply), Delaware ($100 per 30 day supply), New York ($100 per 30 day supply), Utah ($30 per 30 day supply), West Virginia ($100 per 30 day supply), Maine ($35 per 30 day supply), New Mexico ($25 per 30 day supply), Virginia ($50 per 30 day supply), Washington ($100 per 30 day supply), or New Hampshire ($30 per 30 day supply) and you buy a state-regulated health plan, you are eligible for a copayment cap on insulin (implementation dates pending, but Colorado was the first bill to be implemented and it went into effect January 1st, 2020).

Check the fine print of any health insurance plans on the federal or your state’s exchange to see if they are eligible for the copayment cap. More states are introducing legislation in 2021, so keep an eye out for a bill proposing some similar changes in your state!

Get Help Paying for Supplies

Several companies have launched affordability programs in response to the COVID-19 pandemic. A few new programs are:

  • Dexcom: Is offering up to two shipments of 90-days of Dexcom G6 Continuous Glucose Monitoring System supplies, with each shipment consisting of one transmitter and three boxes of three sensors for $45 per 90-day supply shipment. For existing customers only, if you qualify.
  • Omnipod: Is offering a six-month supply of products (60 pods) free of charge. The program is focused on current US customers who have lost jobs and health insurance as a result of the pandemic.
  • One Drop: This online subscription package charges the consumer a monthly fee, and you get access to cheaper test strips, online personal health coaching, and a mobile app to track your progress. If your health insurance doesn’t adequately cover test strips, this can be an affordable and effective way to go.
diabetes advocacy

Photo credit: T1International Instagram

Advocate for Change

If you see or are experiencing injustice, you should always try and advocate for change. This means writing letters to your elected officials, calling your members of Congress, petitioning your health insurer, testifying for bills that support better health care coverage, and raising your voice to improve policies that will benefit all people living with diabetes. Get involved in the diabetes online community on Facebook or Twitter. Sign up to become an advocate with T1International. Donate to your favorite diabetes charity who’s working to make things better.

Show up at your state capitol and talk to people about what it’s like to live with diabetes, how expensive it is, and how crucial good coverage and affordable medications really are. You can live a great life with diabetes, but coverage, laws, regulations, and policies can always be better. And things won’t improve until we have everyone at the table, advocating for change.

How are you able to manage well with less to spend? What policies or changes would you like to see in the US healthcare system that would make management easier for you? Share this post and your story, below!

Source: diabetesdaily.com

How Do We Afford Our Insulin During an Economic Crisis?

COVID-19 has caused widespread panic across the globe, and that has quickly become apparent given the recent bear stock market, which hasn’t been seen since the Great Recession over a decade ago. You may have seen your IRAs and 401ks plummet in recent weeks because investors are scared.

Some economists are predicting that the United States could even see up to a 30% unemployment rate, as layoffs sore from the mandatory closings of restaurants, bars, gyms, coffee shops, and retail stores across the nation, trying to prevent the spread of COVID-19, the disease that is caused by the novel coronavirus. You may have experienced a recent layoff or reduced hours as a direct result of COVID-19, and if you have, your health insurance may have taken a hit as well (or gone away altogether). So, how can we afford our insulin during an economic crisis? Here is our (hopefully!) helpful advice:

If You’ve Lost Your Job

File for unemployment insurance immediately. Most states require that you’ve lived/worked in the state in which you’re applying for benefits for at least six months to qualify, and you don’t qualify if you quit or were fired from your most recent job. These bi-weekly payments have a cap (depending on your income and the state in which you live), but can definitely help you in the short term until you’re able to find new employment. Congress recently passed the COVID Stimulus Package, which includes expanded unemployment benefits (extending by 13 weeks), and enhances said benefits for four months. The program has also been broadened to include freelancers, furloughed employees and gig workers, such as Uber and Lyft drivers.

Special Enrollment Period

It’s well-known that one must sign-up for health insurance during “open enrollment”, which is a time period, usually once a year, when individuals and employees of companies and organizations may make changes to or buy different health insurance plans. Under the Affordable Care Act, a change in your personal situation, such as getting married, having a child, or losing your health coverage (by way of losing your job) makes you eligible for a Special Enrollment Period, which allows you to enroll in health insurance outside of the typical open enrollment period.

In response to COVID, many Governors are creating SEPs (Special Enrollment Periods) to specifically address people’s concerns over having health insurance and affording their medication during the global pandemic. If you currently do not have health insurance (by choice), but are worried about affording your insulin, or are particularly concerned about contracting COVID19, you may be able to take advantage of a SEP in your state.

See If You Qualify for Medicaid

As of now, 36 states have expanded eligibility for their state Medicaid programs (to 138% FPL), which offer extremely affordable insulin and diabetes care. If you’re a low-wage worker whose employer doesn’t offer health insurance, and you can’t comfortably afford to buy a plan, see if you qualify for Medicaid. Many Governors are looking into expanding Medicaid even further during the national public health emergency.

Cash Relief is Coming

Congress recently passed a $2 trillion Coronavirus Stimulus Package that includes direct cash payments to all American taxpayers. Lawmakers agreed to provide $1200 in a direct (single time) payment to taxpayers making up to $75,000 per year, with $5 less for every $100 per year a person makes all the way up to $99,000. Families will receive an additional $500 per child, in an attempt to create a safety net for people whose jobs and businesses have been negatively affected during this public health turned economic crisis. This bump of cash will help millions of Americans, including people with diabetes, afford their medications easier in the short term while longer-term policy solutions are worked out to help everyone during this crisis.

If All Else Fails, Reach Out for Help

If you’re still struggling to afford your medication, you can reach out to your insulin manufacturer for help: Lilly Cares, NovoCare, and Sanofi Patient Connection can help get you free or discounted insulin when you’re in a desperate spot. Currently, insulin manufacturers are not anticipating any supply-chain issues as a result of COVID-19.

Additionally, the diabetes online community (on Facebook, Instagram and Twitter) is an amazing resource of dedicated activists and helpful hands who are always more than willing to help fellow people with diabetes in need. Reach out to your friends and family and let them know you’re struggling. Ask your doctor if they have any samples of insulin you can take from the clinic for free. Let your struggle be known, so people can help you. Do not suffer in silence.

Have you had issues affording your medications and/or insulin during this global pandemic turned economic crisis? What strategies have helped you? Share this post and comment below, we love to hear your stories and suggestions!

Source: diabetesdaily.com

Surviving with Diabetes in Venezuela

This content originally appeared on Beyond Type 1. Republished with permission.By Carmen Sosa Editor’s Note: Carmen Sosa lives in Venezuela with her daughter Sofia, who was diagnosed with type 1 diabetes in 2008. Carmen began working as a donor mother at the hospital where her daughter was being cared for and she is now the coordinator […]
Source: diabetesdaily.com

How and Why People With Diabetes Stockpile Supplies

For people with diabetes, an interruption to insulin supply is quickly life-threatening. It’s also seriously problematic to endure a disruption in other diabetes necessities like glucose test strips or CGM (continuous glucose monitor) sensors or insulin pump cartridges. Many people with diabetes strive to have a small stockpile of back-up supplies because what do we do […]
Source: diabetesdaily.com

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