Managing Diabetes Without Health Insurance


 

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.



“How will I pay for my meds and diabetes supplies if I don’t have insurance?”

For many people, this is a constant source of stress, worry, and fear. While we work to help lower the cost of insulin, the reality is that diabetes is expensive.

If lose your job, your current employer doesn’t offer health insurance, or you age-out of your parents’ insurance plan, you may find yourself panicking because affording the demands of diabetes is not easy.

However, there is power in knowledge. It’s important to get on the phone or get online and reach out to the manufacturers of your insulin or diabetes supplies. Information and awareness will help empower you in the event you do find yourself without health insurance

Here’s what you should know…

Insulin

Eli Lilly insulin & medications:

Novo Nordisk insulin & medications:

Sanofi insulin & medications:

MannKind Afrezza inhaled insulin:

Older insulins NPH & Regular:
At Walmart, you can buy NPH and Regular insulin for $25/vial if you qualify for their program.

Insulin pump & CGM supplies

Test-strips & glucose meters

  • Accu-chek: Test-strips & meter
  • Contour: Test-strips & meter
  • Freestyle: Test-strips & meter
  • OneTouch: Test-strips & meter
  • ReliOn: Affordable test-strips and meter can be found at Walmart stores or online

Today, there are also several glucose meter companies that require no prescription and no health insurance. Their prices are often more affordable than paying for test-strips with a co-pay. These independent companies include:

Organizations that help people afford medications & supplies

These organizations aim to serve people who are struggling to afford prescription medications and medical supplies. Each one operates a bit different, and some are dedicated entirely to people with diabetes.

Insurance resources

As the 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

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. 

Healthcare Exchange

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

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

Insulin 

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 these below 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.

WRITTEN BY Julia Flaherty, POSTED 03/30/20, UPDATED 04/28/21

Julia Flaherty is a Digital Marketing Specialist at Ledgeview Partners, and Professional Writer, Editor, Content Marketer, and Social Media Strategist. She is a Health and Equality Advocate who aims to create positive and lasting change for people throughout her career. In 2019, she started the Wisconsin Insulin Price Cap Support Petition.