Let me be the first to say we have good health insurance, for which I am thankful, but many people do not. Type 1 and type 2 are expensive diseases for the patient and the insurance company. The burden of caring for a chronic disease with no or inadequate insurance is stressful and cruel, particularly for a disease of higher occurrence in a pediatric population. I read posts from families in the Diabetes Online Community (DOC) where there’s a six month or year waiting period for a pump or CGM, or only a certain number of test strips are covered. Underinsured diabetes care is thick with irony. For many people with T1D, pumps and CGM’s are the very products that make management easier, and thus decrease the chance of negative long term complications, but these are the products for which the insurance companies can have extreme waiting periods. Thick with irony. Sometimes, there are insane diabetes moments, which can run the gamut from frustrating to humorous, but there’s always a touch of irony. Here’s mine from last week.
The scene: chain drugstore, mother picking up a prescription twelve hours after returning from vacation, which included attending a diabetes conference, a 7 year old non T1D child is accompanying the mother on this pre-lunch errand and intermittently asking for candy that is for sale on the drugstore counter, pharmacy tech places several large bags on counter…
Mother: And the test strips are in the bag?
Pharmacy Tech: (looking through 4 prescription sheets) No, it doesn’t look like it.
Mother: But I got this text from you (shows text) seven days ago saying the prescription was ready for pick up.
Pharmacy Tech: We text you when the prescription hasn’t been picked up in 1 week.
Mother: I have the test strips on autofill, and we were out of town at a diabetes conference.
Pharmacy Tech: We text one week after no pick up and then we can only hold the prescription for one more week after that. After 14 days we have to return them because insurance won’t let us hold them for longer. If you haven’t picked them up in 14 days, the insurance thinks you don’t need them.
Mother: I had no idea about this policy. My son needs these test strips, that’s why I’m here. We have five test strips at home, not enough to get through the day.
Pharmacy Tech: You can buy them out of pocket.
Mother: How much will that be?
Pharmacy Tech: Let’s see. At $1.40 per strip, hmmm, that’s more than I thought they would be, with a prescription of 400, that would be $560 dollars.
Mother: Wow, just wow.
Pharmacy Tech: Yeah, that’s a lot. Insurance won’t cover these until next month, but you can call us a week early and we can try to fill it early if that will help.