Suddenly Jobless or Without Health Insurance? Start Here.
Editor’s Note: People who take insulin require consistently affordable and predictable sources of insulin at all times. If you or a loved one are struggling to afford or access insulin, click here.
With rising unemployment rates due to the COVID-19 global pandemic, many Americans are concerned, especially those with chronic health conditions like type 1 diabetes. While the last thing we want to worry about now in the type 1 diabetes community is unemployment and no healthcare coverage, it’s important to know how to handle the situation if it becomes a reality for you.
The first question many people in the type 1 diabetes community will ask is: “How will I pay for my meds if I don’t have insurance?”
Many people in the type 1 diabetes community already struggle to answer this question outside of this global crisis and with their existing insurance, so the idea of it becoming completely unavailable may feel jarring. However, there is power in knowledge. Information and awareness will help empower you in the event you become unemployed.
There are workarounds that can help you sustain your insulin and testing supplies should this happen. Here’s what you should know:
New COVID-19 programs
Some insulin manufacturers have instituted new programs and policies to help efforts in the midst of COVID-19. Please note: you can find out if you may qualify for each of these programs, as well as find other programs to potentially lower the cost of your insulin, by going to GetInsulin.org.
- Lilly introduced a new program offering $35 monthly copays for their insulin for anyone with commercial insurance or without insurance. People who use Lilly insulins can contact the Lilly Diabetes Solutions Center to take advantage and get more information by calling 1 (833) 808-1234.
- Novo Nordisk announced the company would offer a free 90-day supply of insulin to those recently without insurance. For more information, visit novocare.com or call 1 (844) NOVO4ME (668.6463).
- Sanofi has expanded their Patient Connection program – those already using the program are allowed to reorder their prescription(s) early, those who qualify for the Temporary Patient Assistance Program will receive 180 days of prescription(s) coverage instead of 90 days, and financial documentation requirements have been eased, recognizing unemployment documentation may be delayed. Visit sanofipatientconnection.com or call 1-888-847-4877.
Some device manufacturers have also announced new COVID-19 assistance programs:
- Medtronic announced an expansion of the Medtronic Assurance program with a new option to support diabetes customers who have lost their health insurance due to COVID-19-related job loss. Current eligible U.S. customers can now receive a 3-month supply of glucose sensors, infusion sets and reservoirs at no cost. Visit medtronicdiabetes.com/assurance to assess eligibility and learn more about the program.
- Insulet expanded its current U.S. program, stating those who meet the criteria can qualify to receive up to a six-month supply of pods.
- Dexcom announced a new program to launch in the next several weeks. For qualifying U.S. customers, Dexcom will offer up to two shipments of 90 days of supplies and a reduced patient cost to $45 per 90-day shipment.
As JDRF points out, in many cases you will have health insurance coverage through the end of the month of your qualifying event. Take advantage of that time to refill and renew prescriptions (a 90 day supply, if possible) and fit in a telehealth visit with your healthcare provider to go through next steps. Apply for other insurance and patient assistance programs, detailed below, while your coverage is still in place to minimize the gap between healthcare as much as possible.
COBRA (the Consolidated Omnibus Budget Reconciliation Act) is a health insurance program that allows an eligible employee and their dependents to continue to have access to health benefits in the event that they lose their job or experience reduced hours.
If you are unexpectedly laid off or lose your benefits due to the COVID-19 pandemic, your employer may offer you this if they meet certain criteria; businesses with 20 or more full-time employees are usually mandated to offer COBRA coverage.
In order to qualify for COBRA, as an employee you must have been enrolled in your company’s sponsored group health insurance plan on the day before the qualifying event occurred. The qualifying event must result in a loss of the employee’s health insurance. This means the employee has suffered:
- Voluntary or involuntary job loss (except in the case of gross misconduct)
- A decrease in the number of hours the employee works that result in a loss of employer health insurance coverage
From the date of the qualifying event, COBRA coverage extends for a limited period of 18-36 months. However, the employee may qualify to extend this period if qualified beneficiaries in their family are disabled and meet certain requirements.
In the event you become unemployed, COBRA may be an option but may not be the best option price-wise. With COBRA, individuals are usually required to pay the entire health insurance premium, including whatever part of the premium was previously being covered by the employer, and at times responsible for a 2% additional administrative charge.
Anyone who has experienced a qualifying life event, such as losing their job or health insurance coverage, is eligible to attain health insurance through the healthcare exchange. This is the same program through which you can see if you qualify for Medicaid or CHIP. Visit Healthcare.gov or call 1-800-318-2596.
Editor’s note: When picking a plan, utilize this Health Insurance Guide to help you navigate premiums, deductibles, and other important elements to consider when choosing the best plan for Type 1 diabetes coverage.
Medicaid is a government issued health insurance program for low-income and disabled people. The American Diabetes Association reports that 3.5 million people with diabetes use Medicaid for some or all of their medical care. Medicaid is not the same as Medicare.
DiabetesSisters.org explains the differences best:
“Medicare for older individuals is not dependent on the individual being poor. Medicaid, however, has restrictions on the amount of assets any individual may have and/or the amount of income an individual can receive to be able to receive Medicaid assistance.”
These specifications are determined on a state level. Required benefits of every state in the U.S. include:
- Inpatient and outpatient hospital services
- Doctor office visits
- Laboratory and X-ray services
- Long-term care services
- Community-based care
According to DiabetesEducator.org, patients enrolled in Medicaid should consider options like this with their endocrinologist (or other doctor helping them manage their type 1 diabetes):
- Insurance plan formulary alternatives
- Prior authorization processes
To understand exactly what is covered by your state and to see if it’s right for you, visit Healthcare.gov or call 1-800-318-2596. If you are unemployed, you and your loved ones may qualify for low-cost coverage through Medicaid or the Children’s Health Insurance Program (CHIP).
Additional cost-saving options
A variety of manufacturer-offered patient assistance programs ($0 out of pocket, for those who qualify) and copay cards ($15-99, with options available for those with and without insurance) are available for every type of insulin. More people qualify for $0 out-of-pocket cost patient assistance programs than many assume. To find out if you qualify and for the many other resources available to lower your out-of-pocket costs for insulin, visit GetInsulin.org.
Blood sugar testing supplies
Being aware of our blood sugar levels at all times is an important element of our care. While becoming unemployed and underinsured or left with no insurance can mean we may be left without our (necessary) continuous glucose monitor (CGM) supplies, we still have options. Test strips are not the best form of blood sugar management, but they are better than nothing.
Companies like One Drop, Diathrive, and Livongo offer customers diabetic testing supplies for a flat monthly fee. The services come with a glucose meter, lancing device, and carrying case with your first order, plus a monthly supply of test strips.
To further support low-cost medications in your state, you may also consider supporting the petitions for insulin affordability with Change.org or start one of your own. Almost 1 million people have signed their names already to help the Type 1 diabetes community. Click here to sign petitions for low insulin costs across the United States.
Hang in there – we are here to provide the resources, care, and support you need to thrive throughout the year and especially during crises like this.