D Blog Week 2017: The Cost of a Chronic Illness

Insulin and other diabetes medications and supplies can be costly.  Here in the US, insurance status and age (as in Medicare eligibility) can impact both the cost and coverage.  So today, let’s discuss how cost impacts our diabetes care.  Do you have advice to share?  For those outside the US, is cost a concern?  Are there other factors such as accessibility or education that cause barriers to your diabetes care?


"Money money money" is very relevant when you have t1.

I'm so frustrated by what's happening in the US right now. People are trading insulin on Facebook because their insurance only covers a particular type. People are paying hundreds of dollars for scripts. People are dying from trying to ration their insulin to their next pay cheque. On top of that, politicians, people who make decisions, are blaming people with diabetes for their condition. They say they're not worthy of being covered by using inaccurate stereotypes of people with type 2 diabetes. None of that is okay and I am so sorry it's happening to you. I am fortunate enough to live in Australia where right now access to basic supplies is okay. I can't fix what's going on in the US, but I'm certainly thinking of you all. My financial access concerns are nothing compared to what's going on over there.

I'm a big believer in public health being high quality healthcare. I think that whilst imperfect, Australia does a more than reasonable job. Diabetes is a costly condition to have when you consider the blood glucose testing equipment you need, alongside the insulin delivery items and hypo treatments. That's just the minimum. I use an insulin pump which thanks to my parent's health insurance is provided free of charge. So now you can add in pump consumables to the running price. Plus a private endocrinologist and diabetes psychologist adds on an extra grand or so for the year. 

I also use a CGM (sensor that monitors your blood sugar 24/7), which until recently has been considered a luxury item. No amount of private health insurance would cover the cost of a CGM. Garbage when you consider a CGM can literally save lives if you go low overnight. I didn't realise living and actually sleeping at night were luxuries. My mistake.
CGMs are now subsidised for people under 21 which has been a big step forward in recognising their merit.

I started a CGM in January this year. Staying on a CGM system full time is an expensive endeavour, so I never considered it an option. I pay for all of my diabetes supplies and specialists independent of my parents, and it just wasn't something I could afford. Eventually my blood sugars and a1c (3 month average of blood glucose "control" for lack of a better word) were mismatched. My sugars were high and my a1c was great. Turned out I was having low blood sugars in my sleep and not waking up. Each time I was lucky enough to have my own body fix it for me, but that doesn't always happen. It was around the time of my 21st birthday and Christmas so I decided to ask my family to contribute financially toward a CGM system for a year. It wouldn't be enough to pay the lot, but just enough to take the edge off the financial burden.

As usual they blatantly ignored what is a typical amount to spend on a person and covered almost half of the yearly cost. I may have wanted to throw the CGM off a really high cliff for a month or so there (you wouldn't believe how guilty I felt when I hated it at first) but now it's my most valuable diabetes tool. Thank you again my lovely, "ignore any kind of guideline Bec tried to set on spending" family. 

But once I finish my degree, cost is really going to become an issue. There are no benefits provided by the government for having type 1. I currently receive a health care card because I receive a student payment from Centrelink. Once I'm no longer a student and have a job, that gets taken away. I have to start repaying my university fees. I have to start paying full price for test strips to check my blood sugar. I currently pay $2.60 for a box of 100. I believe they're normally somewhere around the $13-15 mark. I have to get my own private health insurance to continue insulin pump therapy or I'll be back on the injections I loathed. CGM? Yikes. I'm not sure what's going to happen next year for my diabetes care.

All this and I'm just about to be grouped in the government's stereotype of young people being "too lazy" to move out. Please. I'd like to see you come from a lower middle class family, pay for all of this and find a place to live in Sydney.


Check out what others had to say on the subject: http://www.bittersweetdiabetes.com/p/2017-participant-list.html
Facebook: https://www.facebook.com/adiabeticsrollercoaster/
Twitter: https://twitter.com/sweetandsourt1

Comments

  1. Aww, it would be so hard to go from having CGM coverage before 21 to not having it after. And 21 is such a tough age. I don't know much about health insurance in Australia so thank you for sharing!

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    1. Yes I didnt think of that. I was too old when it came out this year (boo) so have always had to pay. Medicare is good and we also have the NDSS for a price reduction of diabetes supplies. So everyone at least has those 2 things for general supplies :) private health insurance is good if you want a pump.

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  2. Wow!! I really like this topic because it shows how hard it is for everyone, regardless of what country we live in. (I mean, I don't LIKE that it's hard for all of us, but I mean the topic is a reminder.)

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    1. Totally on the same page. It's not perfect anywhere unfortunately :(

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  3. One ER visit because of diabetes would cover a whole lot of CGM supplies. It's so ridiculous. Nice to meet you!

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  4. Perth is where it's at if you want your own place! CGM is really costly, and really glad that your family helped you out. Hopefully you get a spectacular job as a Speechie and you'll be able to pay for it with ease :)

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    1. "Speechie" he's caught the lingo! ;)

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  5. That's rough! I do hope you find a job with good insurance once you graduate. How is the prior conditions issue in the Australian system?
    Also, I'm not sure of the exchange rate but for my test strips here in the US, out of pocket would be $76-$154 for 100. The prices are really all over the place. You can purchase store brand testing strips (i.e. Reli On by Walmart) $17.88 for 100.
    It's hard to figure if more regulation would be helpful. It all depends on who is making the laws. Is the patient really the first consideration or is the the bottom line?
    Anyway, thank you for the post. It is certainly a conversation worth having.

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    1. Oh yikes yes we pay less than you. Really frsutrating. Patients should be the primary concern but it can feel like a money machine at times. I cant tell you much about the pre existing condition thing as I havent yet had to apply as someone with a pre existing condition! Soon...

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  6. Wow, I didn't know that about health insurance in Australia. It is so tough to wonder how you'll pay for your supplies after you graduate... it's supposed to be a time of freedom and opportunity.

    Thanks for sharing and nice to meet you!

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    1. It is frustrating but I'm used to the lack of freedom haha
      Likewise!

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  7. we are really so lucky here in Australia, still hard for so many...interesting to see all of the different experiences today

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