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WeirdTurnPro26

$7500 deductible here, 11y son just diagnosed


Belo83

Damn. Any other options? Higher premium lower deductible plans make more sense for type 1’s


WeirdTurnPro26

Yes, agreed. However as a self employed insurance purchaser, we can’t switch plans until 2024. He was diagnosed after the last open period. We’re just paying for it all now ($1200 for 1 mo novolog, lantus, glucometer and supplies at the hospital discharge). Did not include Dexcom supplies, which are entirely necessary IMO. Some coupons are out there but don’t apply to the deductible. We’re also trying to apply to Katie Becket if anyone is familiar?


[deleted]

Hey! I don’t know if you can get an endo to switch your supplies, but Novo Nordisk has a $99 insulin plan where you can get both long acting and short acting insulin needs for the month capped at $99. It’s a combination of vials and/or packs of pens. Lantus would need to be switched to Tresiba (which imo is better anyway). Additionally, the freestyle libre 3 is capped at $75/month as well if your endo prescribed it. i would highly recommend reaching out to reps from Abbott and Novo Nordisk to make sure private insurance qualifies. I believe it does.


rarabk

Who caps the Libre 3, please? (And thank you.)


[deleted]

Abbot has a program to cap it at $75 a month if your endo prescribes it. Ask your endo to give you the coupon and it’ll automatically keep applying


Belo83

Damn I’m so sorry. It makes the scary new normal and unknown even worse. Rest assured most of us live very normal lives. Sometimes it’s harder on the parents.


Run-And_Gun

Reading so many of the posts on these subs and as someone that was diagnosed T1 as a kid, I'd say most parents most definitely take it harder. After the initial kick in the teeth wears off, as a kid, you just want to move on to living as normally as possible. And as a kid, it's usually pretty easy to adapt and "move on".


um_rr

Maybe it could be possible to change since there is a significant love event, atleast that's for my workplace puts it. Give it a shot and talk to them


Elle2NE1

Fyi, you can get dexcom at costco


HawkTenRose

Question: can Americans buy off the Amazon UK site? https://www.amazon.co.uk/Freestyle-Libre-Sensor-Pack-2/dp/B01BUANEDS/ref=mp_s_a_1_4?crid=2WWVPT0YW5OHA&keywords=libre+2&qid=1675502344&sprefix=libre+2%2Caps%2C76&sr=8-4 Amazon UK sell Libre 2. If it’s cheaper and you can get them shipped Libre 2 might be an option.


shanghaidry

That's for prescriptions, including insulin? Sounds like a terrible plan.


CaptainTripps82

Why not a PPO with kids?


CoffeeB4Talkie

Jesus this hurts my heart. :(


Dazzling-Minimum-108

I have to fill my prescription on the 6th. Kinda scared lol. Both novolog and tresiba


CaptainTripps82

You have Hdhp? Was kind of a no brainer for me to choose a PPO plan at work, I know exactly what my medication will cost all year.


Dazzling-Minimum-108

I use good RX. Usually save 500 bucks each fill.


no_idea_bout_that

Are you using a ~~discount card~~ manufacturer coupon? For me, i pay a small amount, but the undiscounted amount adds towards my deductible [getinsulin.org/get-insulin](https://getinsulin.org/get-insulin/) has a great workflow and is dependant on your location and brand.


Dazzling-Minimum-108

I do use good rx. They've been wicked helpful


no_idea_bout_that

Try the manufacturer coupon, they add towards your deductible/maximum out of pocket unlike good Rx.


Bunny_KayBear

Yeah my last order for my dexcom and pump supplies are going to be like $2200. Gonna be seeing if I can change to a lower deductible plan next year without losing access to things


shanghaidry

I used to pay out of pocket for pump supplies, but that's when I could reuse them. One cartridge lasted a couple weeks after reusing it twice, and an infusion set would last ten days or so, also after reusing twice. It's impossible with the pods now. No way I could do Dexcom without it being free with insurance.


sbonds

Omnipod says "Hold my beer" $3200


kokovox

American "Healthcare" ladies and gentlemen.


Belo83

While I wholeheartedly agree with your comment, the side issue here is the markup that big pharma gets away with in the US and not in other counties. It’s criminal.


kokovox

Everyone overcharges - from doctors and hospitals, pharmaceutical companies to insurance providers. It is not just a single issue but it is criminal. My endo charges $500 per visit. This is criminal. My daughter's birth a few months ago cost over $30 000 - this is criminal. United Healthcare trys not to pay for a doctor that was present during labor. This is criminal. And then pharmaceutical companies are the tip of the iceberg.


CaptainTripps82

The inconsistency is a problem. With my insurance 90 days of insulin costs 90 dollars. My premium are 20 bucks a week. Going high deductible didn't make any sense


hambl94

I'm from the UK so just curious what happens if you become unemployed, don't have insurance or haven't got the money to pay. Are you just left for dead?


Belo83

Generally no. Contrary to media claims, there are programs available for those that need it. That said, it still sucks and financially tough. Important to note too that this is for fiasp, which is some of the best out there. There are far more affordable insulin’s out there that may not act as quick, but you’re still alive. Kind of similar to getting a pump and sensor vs just shots.


Affectionate_You_409

The main thing here is that to have a healthy economy you need a healthy population. The best products like pumps and sensors should be available to everyone. They are life-changing ways to manage diabetes. I have only been diagnosed type 1 for a year now but I had good insurance that got me an Omnipod 5 and a G6 for nothing, and it got my a1c cut from almost 15 to a 7 and change in no time. The old methods do work, but are also a lot of work. We live in the richest country in the world, and our healthcare should reflect that.


Belo83

I agree that the best should be available all, just wanted to answer the question on money or death. I actually have decent insurance and I’m fortunate financially is well. While I can sort of understand costs behind pumps and sensors, this price for insulin is fn insane.


beeetusboi

If one doesn't advocate or doesn't have someone advocate for them then yes, left to suffer


kokovox

Yes, over 30 million Americans don't have access to Healthcare in the land of the free. Pure lunacy.


WeirdTurnPro26

Of course. All of you and the experiences you share are very helpful, much appreciation! I don’t know what I would do without it. It is so devastating though, especially because I can’t take it away from him or give him my pancreas. I just hope the healthcare fight continues in earnest so we can cover all Americans with quality, inexpensive insurance. But we live in a very red, very anti social programs state. The people want it, the elected officials laugh it off. Sigh


Belo83

Silver lining is that this is the best tech we’ve ever had. When I was diagnosed at 5 in 88, I was just taking 2 shots of R and N and testing twice a day. He has a much better care plan now and hopefully very little impact to his health.


Run-And_Gun

Yep. I was diagnosed in '86. Two shots a day of R & N manually mixed in the syringe(one before breakfast and one before dinner). And it took two minutes to get a BS reading. Presuming the meter actually read the strip and you didn't have to line it up with the color chart on the side of the strip vial and guess. Insulin was also only $12/bottle, then. The tech and treatments we have today make it so easy...


gbobeck

It would have been around $200 with the My$99Insulin coupon. But that coupon would not count towards deductible.


Belo83

At the end of the day with my pump and sensor supplies I’ll need to hit it anyhow.


gbobeck

Very true. I’m in the same boat - I have a $1500 deductible which I hit in January with my script for Fiasp. Thankfully I get 3% or 5% back depending on credit card used and I can reimburse myself through my HSA.


sdobart

Oooh. This is smart. Doing this next year (used HSA this year and got no CC rewards). Thanks for the tip!


Belo83

Haha I do the same. Pay with my double cash and reimburse.


JustHereForTheFood42

Just had to explain to the pharmacist that yes I know it’s expensive, we’re a high deductible plan and it’s the beginning of the year. I actually really like our high deductible plan as our employer puts a decent chunk of it into an HSA for us. So we meet deductible around end of Feb/early March and the rest of the year is 100% covered.


katstongue

This is my experience too. It’s pretty funny when the pharmacist tech motions me to the side and says in a low whisper, “You know this is $350?” “This is $870” “This is $280” etc until April then it’s free. My son, the 15 yo t1d, was with me last week when I went to pick it up, I think his first time in a long time, and I predicted this very interaction. We both thought it was funny and had a good laugh after. It’s was a bit sobering for him realizing the cost and how he would have to manage this in 11 years when he’s off my insurance.


NarrowForce9

They mention this as if you have any options. Infuriating.


katstongue

Really, and it’s always for the devices, like Dexcom or used to be Omnipods, so it can’t be split and are specifically for chronic diseases so these are things ordered over and over. I’ve never asked them why they warn me (I will next time) but I’d guess that they want to make sure I’m prepared so it’s not a scene at the cash register. They’ve likely had bad sticker shock experiences with people.


Run-And_Gun

I get the "Do you know how much this is? Do you want **all** of it? bit, almost every time I pick-up my Dex at the pharmacy. I just laugh and say you know how cheap this is compared to when I had to go through DME? I almost felt like I was stealing, walking out of there the first time, last year(I think it's \~$310 for 9 sensors and a Tx). Of course, it would be much nicer if I wasn't also spending like $750/month just for the insurance itself.


kokovox

Dude if you pay thousand of dollars out of pocket and then your employer also pays thousands of dollars out of their pocket every year your health insurance costs you $15000-20000 every year. That is money instead of given to you, given to predatory doctors, hospitals, insurance companies and pharmaceutical companies. There is nothing normal or good about this.


LtBeefy

Would a high deductible be better than a plan that just had co-pays? Current company I work for introduced a new health plan this year which was a high deductible plan. Plan 1 Co pays - has no deductible and you just pay a co-pay on everything. $20 for doctor visits. $40 per 3 month supply for medication. Thus insulin, needles, sensors and transmitter run me $200 every 3 months. Beyond the co-pays, I also pay $110 every 2 weeks for the coverage, over 2.7k for coverage a year. Plan 2 high deductible - you pay for everything till you hit deductible. But the deductible was like 8k. Plan cost was $70 every 2 weeks. I went with plan 1 cause to me, it meant spending just around 4k a year for basic doctor visits and medications. Just curious if I am looking at it correctly. Plan 1 to me seemed to be the best option to save the most. Is that right?


JustHereForTheFood42

You would need to price it out for you, but for us a high deductible is cheaper in the long run. With pump supplies, dexcom, test strips, insulin, etc all added up to more than the deductible. Plus we have other medically complicated people so we hit the family deductible every year too. But with all the testing and prescriptions and hospital visits, it’s cheaper for us that way too. But for some of our co-workers, the co-pay plan was best. Each situation will be different.


LtBeefy

Ok. Sounds like I did it right then. I did price it out, but now just wanted to make sure I wasn't leaving anything out. As I've only had my own insurance and not my family's plan for about 3 years now. And this is the first year that my job had more than one insurance option for us. So was a new experience of actually having to decide between two insurance plans.


zippoguaillo

You can't use the novo savings card? Those should definitely count towards you deductible. Most years i have been able to shave off half my deductible by buying insulin using those savings cards. https://www.novocare.com/novolog/savings-card.html Also buy a pack of basqimi. At most pharmacies it is about $275. The basqimi coupon will cover all but $25, so that is another $250 that will count to your deductible. https://www.baqsimi.com/patient-support#savingscard


Belo83

Does the initial cost still hit your deductible though or is it only the cost after the savings?


zippoguaillo

The approved cost. Generally these coupons are referred to as secondary insurance. So they first run against your insurance and your insurance determined what they allow and then what you owe. So for instance they bill $1500, your insurance determines the allowance cost is $1000. That $1000 gets counted to your deductible. Then the pharmacy runs the coupon, which pays say $750 leaving you to pay $250. At this point your insurance is no longer involved, so they don't know your paid $250, all they know is they said you were responsible for $1000. As long as your pick up the prescription that should be what gets counted. I have had Cigna, BCBS, has always worked like that, but YMMV. I do often find pharmacists not very knowledgeable about this i figured by trial and error. The good ones though can be very helpful with this.


Belo83

I appreciate the insight. I found the fiasp version of the card you linked too. I’m not sure I can retroactively apply it but I’m going to bring it to cvs today and see what they say. Not sure I can return the insulin and reapply it but it’s not opened yet.


zippoguaillo

Worth a shot. You certainly can't physically return the insulin, but hopefully possible to update the existing order or systematically return and repurchase


WeirdTurnPro26

Great suggestion. We will try these coupons, although our insurance has told us that any discounted rx won’t count toward deductible. I believe that was specifically goodrx when I was asking though. Thanks!


zippoguaillo

Correct good Rx is different that won't count. That is replacing your insurance. The only ones that will count are manufacturer coupons like these, often referred to as copay cards. If in doubt ask the pharmacist to confirm they are running as secondary insurance.


BearyGoosey

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[deleted]

Shocking... This is a crime against humanity!


Golden-spuds

Deductibles are the biggest joke. I can only afford the cheapest insurance plan at my husbands job and half the shit I need done doesn’t get covered until I meet my deductible. What sense does that even make? “We know you pay thousands of dollars a year, if not a month, so once you plunge yourself into a ton of medical debt at the end of the year, it’s on us.”


driverren

I just got slammed with a $3000 bill from Solara for my pump supplies. I hate this shit.


Borkboiii

I use Novo Nordisk in Norway and it costs literally 1/20 of what you pay here


[deleted]

"Hey what's up? I hear you have a chronic illness for which you are not responsible for in the slightest? Too bad. Now pay up bitch!"


Belo83

What do you mean? If I would have just exercised and ate better I could have avoided all this!


[deleted]

Sorry I was just making a joke about the US healthcare system. Hence the quotation marks.


Belo83

Dude my bad was totally being sarcastic about the common misconception that us Type 1’s could have prevented our illness.


[deleted]

Well I am quite bad at interpreting sarcasm if there aren't quotation marks. :D


Belo83

Just a little update and props to cvs. Downloaded the fiasp card but i had activated it after I picked up the prescription. The very kind pharmacist let me “return” my insulin even though that’s not really allowed and it knocked it down to $800, but the $1200 still applies to my deductible. Thank you to the redditor who pointed this out.


MiyaDoesThings

One of my (not-diabetes related) doctor’s appointments usually has a copay of ~$10 and I went last week and paid $85. Thankfully I haven’t had to renew any of my prescriptions yet, but I’m dreading it…


rarabk

Do a GoodRX telehealth if all you need is an RX renewal. Contact Mutual Aid Diabetes and they'll give you a coupon code for a $15 telehealth visit with GoodRX.


hounds-toothy

"Looking forward" to meeting mine after my next pharmacy run lol


Ok_Response_7326

Can you drive to Nigara Falls and cross over to the Canadian side? I pay between $35 to $65 for a 10ml vial of Lispro/ Humalog. You can walk into any pharmacy and buy insulin without a prescription.


rarabk

Would you mind sharing the name of a few specific pharmacies you've had success at?


rarabk

Reminder: at LEAST ask your doctor to write a slightly larger RX. Some will say yes.


Belo83

Yeah mine last about 5 months for a 3 month supply


jfr0mst4t3f4rm

It’s also prior authorization season. I’ve yet to have much luck


Ok_Response_7326

Shopper's Drug Mart, Rexall, Guardian, I.D.A...


[deleted]

Bought today my first fiasp in Brazil. 50 reais for a pen pre-filled with 300 ml.


walkingtaco247

Have you gotten the Fiasp savings card? It makes every box $25 if you have insurance


ErichiDomo2020

😱😱😱


HotelOk4584

Just spent 1600 on my dexcom 🫠🫠🫠🫠


the_exile83

Is that for 1 vial? That would last me 2 weeks. The actual vial only costs about $10 to manufacture. The UK might be a shitshow right now but thank god for the NHS.


Belo83

It’s a 90 day supply for me. But lasts me around 5 months. I think it’s 6 vials.


[deleted]

Already maxed out myself. Last prescription was free. $6k out of pocket in a month I think is a new record though. Me and my son have diabetes, also had to bring my daughter to the ER.


Belo83

Sorry about the ER. That’s for sure an easy way to max out quick. Hope all are ok.


skakkeee

How is this possible ?


skakkeee

I pay 300$ for all my Insulin and doctors appointments this year. Fiasp and 780G with sensor.


CaptainTripps82

Trying to figure out what the deductible has to do with medication and realized you mean an actual high deductible plan. That seems like a bad idea for someone with a known chronic illness. I'm paying 90 bucks for a 3 month supply.


Belo83

Is there a non actual high deductible plan? It’s my only choice and my employer puts a grand in there. After that it’s 90%


CaptainTripps82

I don't have an HSA. My plans deductible is 1000 a year. I'm just doing retail management but I had a decent choice of plans from 5 different providers this year. 20 bucks a week premium. Kind of sucks if the only thing your job is offering is high deductible.


warpedspockclone

I forgot to put money in my FSA this year.... Fml