Starting a New Job with Type 1 Diabetes

Starting a new job? When you live with type 1 diabetes (T1D), that can come with a mix of excitement, ambition and worry. You may be asking yourself, “How will I protect my health while I build my career?”

A new job should be about proving your skills, not hiding your health. Diabetes management is not a weakness; it’s a daily demonstration of resilience, data analysis, crisis management, and discipline—the skills we use to manage our blood sugars are the very skills we bring to the workplace.

Your new job is a fresh start. Follow these steps so you can walk into that first day confident in your professional abilities and in your health security at the same time. 

Find out what your health insurance options are ASAP

Ask for the health insurance plan offerings before you accept a new job, ideally during the negotiation phase when you’re evaluating the benefits package. The more time you have to study and understand what’s available to you, the better.

If getting health insurance details before you accept an offer isn’t possible, you should meet with human resources (HR) to take a look at your health insurance options as soon as you start. 

There are typically a few different choices and price ranges, with the more expensive plans offering more benefits, especially for people living with a chronic disease like diabetes. 

What to look for when you pick a new insurance plan

As a person living with diabetes, the most important things to consider when choosing a new insurance plan include:

• When coverage begins (is there a waiting period?)
• Whether your current endocrinologist and care team are in-network
• How insulin, CGMs, pumps and other supplies are covered (medical benefit vs. pharmacy benefit)
• Deductibles, co-pays, and out-of-pocket maximums
• Whether prior authorizations or appeals will be required for your current meds and technology
• Coverage and medication tiers for all medications you’re currently on. Most major insurance companies have a search tool on their website

When does health insurance kick in at my new job?

That depends on your new employer. Always ask, never assume. Many companies have a waiting period for coverage between your employee start date and when your benefits actually start. 

If you’re transitioning from one employer’s health plan to another, try to overlap coverage if possible. Gaps in coverage can be costly, dangerous and stressful. Typically, when you leave a job, you have health insurance coverage through the end of the month. 

Ideally, you want to finish your previous job at the beginning of the month, have health coverage through the end of the month, start your new job mid-to-late in the same month, and your new coverage will kick in (most of the time) at the beginning of the following month. This ensures continuous coverage.

Do not wait until your company’s open enrollment period(the time when you can sign up for yearly coverage) to review your offerings. Starting a new job is a qualifying life event that means you can start receiving healthcare outside of open enrollment periods (which is usually in the fall). 

Yes, you’ll need brand-new prescriptions 

This can be a headache. Prescriptions are run through insurance, and when your insurance changes, you’ll need new prescriptions for all of your current medications. This can include insulin, pump supplies, CGM technology and any other regular medications that you take. 

Some providers require an in-person visit to renew prescriptions, so schedule an appointment with your doctor as soon as possible to get fresh prescriptions and avoid delays, having to pay out of pocket, or going without what you need.

In some cases, the medications you’re on may not be covered by your new insurance or are on a lower (more expensive) tier. Check your insurance formulary to be sure and talk with your doctor about medication alternatives if this is the case. Your doctor can also start an appeal process to get your medications covered right away. 

Your pharmacy will also need your new insurance information. You’ll need to provide your pharmacist with your new insurance ID card so they can verify your prescription benefit information and determine copayments and cost-sharing through your new insurance plan.

Consider a health savings account (HSA) 

If you decide on a high-deductible health plan, you may want to consider a health savings account (HSA). High-deductible health plans typically have a lower monthly premium, so they’re cheaper each month, but you must meet a certain dollar amount spent on medications and supplies before any coverage kicks in 

HSAs can be powerful tools. They are basically a savings account that you make with pre-tax contributions that have tax-free growth and tax-free withdrawals for qualified medical expenses. 

For those of us with a predictable, ongoing need for diabetes supplies, that tax advantage matters. If an HSA isn’t available, consider a Flexible Spending Account (FSA) to offset predictable out-of-pocket costs for medications and supplies.

Get familiar with your employer’s PTO  policy

It’s important to know what your time off looks like. Do you live in a state where vacation days don’t expire and roll into the next calendar year (like in CA, CO, MT and NE)? 

Are your sick days and vacation days collected in one bank, or are they separated? How many sick days do you get per year, and do they expire at the end of the year? Do you have to take time off for every hour missed from work, or does your employer let you leave for doctor’s appointments or if you’re feeling sick without docking your leave bank?

This can help you plan out doctors’ appointments and your leave (sick or fun!) throughout the year. 

It’s better to know before you need to take it. 

Know your disability rights and what to disclose

As a person living with a disability under the Americans with Disabilities Act (ADA), you have rights and reasonable accommodations that are protected by both state and federal law. 

You do not have to disclose your diabetes to anyone at work. You are protected under the ADA whether or not you choose to tell anyone about your diabetes.

Some accommodations that you are entitled to may include:

• The ability to keep diabetes supplies with you at all times while at work
• The ability to test your blood sugar whenever you need to 
• The ability to take insulin whenever you need to 
• Breaks to treat low or high blood sugars 
• The flexibility to have low snacks with you, even in places that don’t typically allow food
• A private space for medical needs, like taking an insulin shot or changing a pump site 
• Flexibility for medical appointments

Whether or not you share your diabetes with your employer is completely up to you. You are not required to share your diagnosis during the hiring process. Once employed, if you need accommodations, you can disclose your diabetes to HR or your supervisor. 

Frame it clearly and confidently: “I live with type 1 diabetes and may occasionally need brief breaks to manage my blood sugar.”

Most employers want you to succeed. Clear communication helps ensure they understand what that support looks like.

Evaluate short- and long-term disability coverage

Disability coverage protects your income if you’re temporarily or permanently unable to work. Many employers offer disability insurance as part of their benefits package. You should enroll if it’s available. While most people with T1D live full, productive lives, complications or unexpected health events can occur. 

Disability coverage not only protects you, but also your family from financial ruin, should you need to stop working due to your diabetes at any point.

Review the fine print. Understand the elimination period, percentage of salary covered and whether the policy is employer-paid or voluntary. If it’s voluntary, consider whether the premium fits into your financial plan.

Build your emergency plan

High and low blood sugars will happen at work. It’s important to know what to do and who to lean on. 

• Introduce yourself to at least one trusted colleague and let them know, in simple terms, what to do in case of a severe low blood sugar. Keep glucagon accessible and ideally have at least one coworker who knows how to administer it to you in case of an emergency
• Wearing a medical ID at work is also helpful
• Store extra supplies, including insulin pump and CGM supplies, syringes, insulin, and low snacks at work if possible
• Juice is shelf-stable and always good to have on hand

These small backups reduce anxiety and keep minor mishaps from becoming major disruptions. 

Advocate for yourself without apology

Starting a new job is a big deal! Through this new chapter of growth and purpose, give yourself grace. It’s a transition. New schedules can mean changing basal rates, adjusting meal timing, or navigating stress-induced highs. That’s normal. Just monitor your body closely in the first few weeks and work with your healthcare team to fine-tune as needed.

You deserve both a thriving career and well-managed diabetes. And with the right groundwork, you absolutely can have both.

Diabetes comes with few benefits. Use your rights! Looking for a safer space to connect? Join our community to share your story and get your questions answered.