Insurance Changes and Harsh Realities


Type 1 was not something I thought too much about growing up. It was dealt with, kept in control, adjusted when necessary, but mostly on the sidelines of my thinking. Never in a million years did I let it influence my dreams. Being a professional photographer was what I worked tirelessly for as long as I can remember. It’s one of those jobs that people know exist, but can’t fathom finding themselves in the reality of. It took endless effort, but I’m writing this from my open air platform in the Los Tres Brazos Valley of Panamá, where I’m the photographer for a sustainability institute in an off-the-grid campus. I am surrounded by enthusiastic minds testing and developing best practices for sustainability in the tropics. One of my semester goals is to start a photographic archive of the insects surrounding us. We are in one of the biodiversity hotspots of the world. Our biology director says if we spend enough time at the mountain hut in the Chagres National Park just north of us, we can find and be the first to record a new, unidentified species. These things, this wild life, is my dream realized. That dream also doesn’t include posh health insurance or Statesian size paychecks.

A few weeks ago, my insurance was solid, my supplies were world class and my entire paycheck wasn’t needed to have access to such. Now, I sit in a totally different reality. I recently got an e-mail that let me know that my coverage was being changed because “there was no documentation of hypoglycemic unawareness, frequent hypoglycemia, nocturnal hypoglycemia, wide fluctuations in blood glucose levels, or discordant HB A1c levels.” Shortly later I learned of a changed deductible. Now, I am in the position where ordering anything through my plan is a dream of a far off land, rather than any approachable reality. Hours into a phone call with my insurance company, I found myself saying that all of my future shipments of pump and continuous glucose monitor (CGM) supplies needed to be stopped—that yes, I did need to stop receiving the exact things that keep me in good control. It makes no sense, but neither does health insurance with a $15k deductible. It’s a very strange feeling—knowing that I’m putting in a pump site and CGM sensor today and that my time with these luxuries is coming to a fast end. At almost 25 years old, I still have a year left on my father’s insurance. With its changing conditions, I am already in the position where I simply can’t afford to use it. Never before have I cried about this disease. Never before have I thought about leaving my dreams to go to a life that can pay for good health. This week, those instances have been countless.

This isn’t to say that my world is ending. What I need to survive is still available to me. My test strips now come from Good Glucos, a company that is doing more good than I can begin to fathom. No insurance, pharmacies, or deductibles will influence that supply chain. My insulin is affordable because I’m a member of a Mexican pharmacy chain that doesn’t rob its customers for having a lifelong disease. I’m still figuring out how I can take advantage of that without having to go to Mexico every time, but Amelia at Farmacias Benavides in Hidalgo, Nuevo Leon is as sweet as can be and the rock climbing up the road is world class, so if I have to continue yearly visits to get life saving medicine, I’ll oblige.

It’s not just me living my crazy, non-conventional life that is facing these changes. Working on the 7th floor of a glass building and talking to screens as much as you talk to men in sharp suits used to mean your health care would not be a worry. My brother, also a type 1, is learning that just because he wears a tight tie to work every day doesn’t mean his health insurances issues are put at ease. Pre-existing conditions have never been more of a problem and as far as we can tell, the situation is only getting worse. It has never been more daunting that diabetes isn’t going anywhere.

The future of all of this is not certain for me. It’s looking like syringes and quasi-black market test strips will soon become my only diabetes supplies. Right now, I know my blood sugar went up to 132 from 127 five minutes ago and I’m dialing in .2 units to bring that down to perfection. These luxuries I’m cherishing, using a laughable amount of tape to keep these dwindling supplies attached to my body while I still have them.

Read Insurance—Navigating Denials.

Read more from Carter HERE.

WRITTEN BY Carter Clark, POSTED 10/16/17, UPDATED 07/25/23

Carter Clark has been in motion for the majority of her life. She spent much of her adulthood in Panamá, but is now back to being all over the place. As a climber, she tries to spend more time in the mountains than anywhere else. She is a professional photographer and has had type 1 since 1996.