Health insurance battles. They are something we have all had to deal with (at least those of us who are fortunate enough to have insurance). Don’t get me wrong, I never take having health insurance for granted, I lived for many years without it, including the first few years after diagnosis. And honestly compared to many people I know, I have great insurance as far as what they cover and what I pay. But I do have to spend time fighting certain decisions they make. Most T1 diabetics have to pretty regularly. And most of the time we are fighting for what we need to stay alive!
For the last few years, the insulin I use is no longer a preferred brand with my insurance. I am one of those people who easily gets side effects to medications and insulin has been no different. So when I tried my current insulin (Humalog) and tolerated it with no side effects, it was a blessing. Then my insurance didn’t want to cover it anymore. Despite my well documented history of side effects, my insurance decided I needed to try insulins a, b and c before they would approve Humalog but they did eventually approve it. Then two years later, they denied the exception to cover Humalog again and gave me a list of 3 more insulins I needed to try. Thankfully I’d already tried two of them earlier in my diabetic journey (before I had my current insurance). But going through the process again meant a delay of 6 weeks before I was able to once again get my Humalog. But like most diabetics, I keep about 6+ months worth of insulin stockpiled for these kinds of situations! We have to because we literally can’t live without it.
Then there has been my CGM (continuous glucose monitor) battle. The brand I have been on since May has never worked well for me. The readings are regularly inaccurate, not always a lot but enough that I still have to test my BG with a finger prick all the time. I tend to bleed a lot at the sensor site. Even a rep from the company I’ve been with admitted that their brand is probably not the best for me. My insurance covers a different brand but my HMO didn’t have a contract with any of the pharmacies that carry it (CGM and pump supplies are only available through mail order pharmacies). So it’s been a 3 month battle to get all the right paperwork to the right department, for my HMO to understand the problem and for the right person there to find a solution. But today I found out that it has been approved! It is such a great feeling when the hard work pays off â¤ï¸
It is fair to say that most T1 diabetics spend hours each year fighting with insurance to get something needed covered. It’s a part of living with a chronic health condition, not just T1D. But I never take what I get for granted, I choose to be thankful for everything provided. There are still many countries (particularly those with socialized medicine) where insulin pumps and CGMs aren’t covered except in the most extreme situations because they are considered unnecessary. Many T1 diabetics around the world don’t have access to the newest technology to make managing their disease easier. I have a lot of compassion for those people and pray that one day they would get access to what we have here in the US. Despite the difficulties, there is so much I have to be thankful for â¤ï¸
