Diabetes Self-Management Blog

What does the Affordable Care Act (the ACA, also known as “Obamacare”) mean for people with diabetes? ACA makes some changes that should help people with diabetes, and some that maybe aren’t so good.

I’m not talking about ACA’s long-term effects on the health-care system or the economy. We’re just talking about immediate impacts on people with diabetes. The most important positive is that plans will no longer be allowed to deny coverage because of diabetes.

According to the American Association of Diabetes Educators (AADE), “Starting in 2014 job-based plans and new individual plans aren’t allowed to deny coverage, charge more, or refuse to cover treatments due to a pre-existing condition such as diabetes.” Many readers have probably been denied coverage in the past. Have you noticed a difference with ACA?

Another good thing: ACA requires “free preventive care” from most plans. This includes diabetes screenings for adults with high blood pressure and for pregnant women. It also requires “medical nutrition therapy” for people with diabetes. But the rules vary by state. What has been your experience?

AADE believes that diabetes self-management training (DSMT) will be more readily covered under ACA, but we don’t know the exact status of DSMT yet. How much training will be covered, and how much will insurers pay?

In theory, all plans have to provide basic levels of coverage and quality to be sold in the government’s “insurance marketplaces.” Most experts think this is a good thing, but some people are miffed. The coverage they have had for a long time does not meet government standards and is no longer available or is at least are harder to get.

A major negative for young healthy people (though not for people with diabetes) is that they are being forced to buy health insurance or pay a penalty. For millions who don’t use health care, whether because they are healthy or because they can’t afford it, ACA adds a financial burden they don’t want. That’s why single-payer coverage like Medicare would be so much better.

Because ACA gives government subsidies for buying insurance, your premium costs could be $60 a month or even less. But low-cost plans come with high deductibles, often in the range of $5,000 a year or more. So for most people, they are only useful in catastrophes like a motor vehicle accident. For someone with diabetes, basic maintenance and care won’t come to $5,000 a year. But if there are complications, you could reach that figure pretty quickly. So you might need to pay higher premiums for better coverage.

The American Diabetes Association (ADA) was a strong supporter of the ACA. On their website, they write that “health insurance is important for people with diabetes to help them access the supplies, medications, education, and health care to manage their diabetes and prevent, or treat, complications.”

ADA gives contact information for each state’s insurance marketplace.

Under ACA, Medicare has started the National Mail-Order Program. It now costs less to have diabetes supplies such as test strips, lancets, batteries, and control solution delivered to your home. According to WebMD, monthly home testing costs could now be as low as $4.50.

Drug costs under ACA should be lower for many people with Medicare. The “donut hole” which suspends coverage after $2,970 has been spent on drugs in a given year, and denies coverage for the next $4,750 of drug costs, is shrinking and will be gone by 2020. After that, drug coverage will be continuous. Good news for people on brand-name drugs and for drug companies.

Things you should know
Writing on Everyday Health, Dr. Ben Hartman lists ten things ACA requires health insurance to cover in diabetes. He suggests that you ask insurers if they cover these things:

• Endocrinologists visits for people with Type 2
• Four endocrinologist visits a year for people with Type 1
• Medical devices (including pumps and continuous glucose monitors if you use them)
• Diabetes self-management education
• Annual eye exams
• Mental health services
• Dental services
• Podiatrist services
• More than one A1C test a year

Cathy Carver, Vice President for Advocacy and Planning at Joslin Diabetes Center in Boston, advises people with diabetes to shop carefully for their insurance. The number of choices can be confusing. Interviewed on the site Type 2 Nation, Carver said,

Focus on three things when it comes to choosing a plan: a plan that doesn’t have high-deductible health insurance, a plan that covers diagnostic tests beyond the preventive screening tests…, and a plan that allows for educational services.

If you’re on insulin, I would ask about device and monitoring equipment coverage as well.

How is ACA working for you? Has it benefited you, or is it causing more problems? Please let us know.

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Comments
  1. Good article, however I would think that ” A major negative for young healthy people “, is not in anyway a negative as far as the rest of us go….

    There are few people in the US that have never been to see a doctor, in their entire life. The time to have insurance is before you have to go see one. The days of needing to go to the ER for something that is not life critical are over. Regardless of your ability to pay, it does not matter. So everyone needs to have Health Insurance.

    At the same time the insurance industry needed to be gotten under control as they have for decades provide little service and overpriced. No one was able to get anything passed in to law that would help any of us, until the ACA. Now the ACA is not perfect, but it is a start and has changed the face of healthcare in the US.

    thanks again for your article

    Posted by William Boling |
  2. ACA = Obamacare = Abominationcare in my book! I work for a small (about 25 employees) privately-owned company that pays (thankfully!) 80% of my health insurance premium. Our new insurance “year” began April 1. The ACA from hell requires ANY insurance plan (whether bought on the “exchanges” or not) to include a lot of coverage that many people don’t need (and before ACA, were not forced to pay for in order to subsidize other people’s healthcare!)For example, my plan is required to cover dental care for children under 19. I don’t have children; my premium still reflects coverage for child dental care. Single men, and women in menopause, are forced to pay for plans that include pregnancy benefits for women, etc.

    There are 4 levels of “acceptable-to-our-tyrannical-government” plans: Bronze, Silver, Gold, and Platinum.
    Our company chose to go with a “Gold level” plan from BCBS. It still provides LESS COVERAGE than I had before ACA kicked in, and it costs a LOT more!

    ***Ready for it?***
    My yearly premium (for one adult)INCREASED BY almost $6,000! (MY annual out-of-pocket premium INCREASED by about $1,100. Thank God my company still pays the other 80% increase. My total annual premium for one adult ***for LESS COVERAGE than I had before*** is now over $13,000!!!)
    My deductible INCREASED BY $1,000 (plus an ADDITIONAL up to $1,500 for hospital stays that was not required in my previous plan.)
    My prescription copays INCREASED BY 40%/50% depending on Tier level. My 2 insulins, needles & test strips will cost me over $500 MORE per year in co-pays.

    Our truth-impaired, logic-impaired and math-impaired President assured us that average health insurance costs would DROP by about $2,500 under his abominable plan.
    Mine have gone UP by about $6,000 premiums & $1,000 additional deductible & $1,500 potential increase for 3-day hospital stay, + $500+ increased prescription co-pays, for a potential $9,000+ INCREASE in healthcare cost for one year.

    I am already a frugal person, and I don’t make a lot of money. I also don’t have a husband to share living expenses, etc. These additional costs for LESS COVERAGE mean the difference between saving for (rapidly approaching) retirement (if I even CAN ever retire, with these horrific increases in mandated healthcare insurance & their associated appalling costs) and possibly having a frugal little mini-vacation once a year, and just barely getting by. I can’t even imagine how folks who earn less than I do and have more than one person to insure are going to survive… but then again, I strongly suspect that the is the communist/socialist plan…

    Posted by Rose |
  3. My insurance coverage DECREASED under the ACA. My company was providing a lot of preventive care (at no extra charge) before the ACA. When the ACA passed, my company cut back on preventive care to match the requirements of the ACA. For example, some of the standard blood tests that were done at my annual physical are no longer covered.

    Posted by Donna C |
  4. My personal experience with this is that my copays have tripled for my insulin and test strips, and my insurance through the state now only covers one blood glucose meter that is faulty and does not work well. I don’t see this as an improvement. Also, according to the glucose meter companies, there is no financial assistance for their products any more, since Obamacare assumes everyone has insurance without regard to how much it costs the individual.

    Posted by Jessica |
  5. It has made it worse. My healthcare provider now has limited the type of glucose test strips and lancets I can get. They have also limited the type of meds we can get. Between Obamacare and Express Scripts I don’t know which one is worse at trying to kill us off.

    Posted by Lisa |
  6. So far, all is great! Thank you!

    Posted by Lin |
  7. While my insurance co-pay went up, I also received added benefits that were not there before. All problems various people face with ACA are probably more due to games played by the insurance companies using loopholes and exclusions to avoid or cut coverages to as a ‘penalty’ imposed on unsuspecting clients.

    Posted by free |
  8. I was diagnosed almost exactly 1 year ago. The diagnosis was the result of my need to get a doctor’s note to be reinstated as a plasma donor which was a semi major source of income. I had been receiving care at a low cost facility in the city I reside. I am very happy to report that my A1C has dropped from an initial 8.4 to a 5.9 (5/21/14) and my bold glucose has dropped from over 180 to average readings in the 90’s to low 100’s. Plus this morning I broke the 280lb. mark from an initial weight of 365lbs. As far as how the ACA has affected my diabetes, I live in Nebraska, which is one of the many states that refuses to accept additional funding for Medicaid, so it has not had an effect one way or another.

    Posted by Jeff Jansen |
  9. My company is still holding onto it’s private insurance plan for another year, however, I am getting hit but repercussions anyway. First off, my Flex spending was whittled down to $2500 as required by the law. As of two weeks ago, that was completely spent. The rest of my medical spending for 2014 will be using money on a post rather than a pre tax basis. This amounts to an addition tax on my income. Also, the new law adds taxes on medical equipment, which includes my insulin pump. Furthermore, my insurance carrier has tightly restricted who can be a source for the equipment and supplies. I now have a single choice, and when that happens, they can, and do, charge whatever they want. This amounts to another massive bite out of my bank account. Finally, I take three prescriptions - all related to my type 1 diabetes. The out of pocket price of all three has risen at least 40% since the implementation of the law. In short, the new law is costing me $150 a month over last year even though I have private insurance. To save money, I am weaning myself off two of the prescriptions (insulin is a must keep). That fact could possibly shorten my lifespan, but it is a risk that I have to take to make my budget work. Heaven help me if my employer throws us into an exchange next year.

    Posted by Rob Gerster |
  10. My coverage decreased and my costs increased substantially. This plan has been nothing but a negative for me and my family. While I support the idea of everyone having insurance, I certainly do not think that I should be penalized so they can have it. Hopefully our next president will repeal this awful plan that has hurt so many people.

    Posted by Kimberly Monaghan |
  11. Interesting article. Since I’m currently covered by medicare I haven’t seen a direct impact. But I have major concerns about the concept of a single payer system. For those supporting it, they need to consider the current situation with VA. If you think that system has problems apply the same approach to the rest of the population and imagine the results. Talk to folks in Canada and the UK. Socialized medicine works great if you really aren’t sick. Works great if you like bureaucrats making the decisions rather than the doctors. When are we going to collectively learn that the one size fits all approach to things really doesn’t work?

    Posted by Mel K |
  12. My flex pen went up to $400 for a month. My unemployment ended on December 28. My diabetic doctor searched and found me insulin in a vail that costs me $40 a month. In May I got a letter from Marketplace telling me that I could no longer have ObamaCare. I now am on a new medicaid, but I can no longer see any of my doctors. I even have to find a new diabetic doctor.

    Posted by littledipz |
  13. after more than 35 years with type-1 and almost a decade without health insurance, it has made a big difference.

    but it’s been no thanks to my provider, which is quite literally driving me up the wall. first, it took them two and half months to get my deductible (which was paid in full) applied to my account, even though i followed their rules to the letter. their customer service is abysmal and unlikely to improve before i change plans. and i’m STILL having problems halfway into the year.

    Posted by meredith |
  14. Diabetic shoes, extremely IMPORTANT and expensive care for a diabetic, is not covered. These shoes should be considered preventive care. If my husband had them when he needed them and didn’t have to wait until we could afford them, he would not be on the verge of losing his foot now.

    Posted by Christy |
  15. I can’t thank Obama enough for passing the Obamacare act! Before the act was passed my husband and I were both in severe financial shape trying to pay our regular bills and having to pay for our own health and dental insurance. We are both self employed and had to purchase our own insurance in the past. I have always kept my diabetes in check so I didn’t have any severe medical needs but regular expenses were still concerning and having to worry how we would pay for an emergency if I did have an emergency was a real stress. I was denied insurance in the past before Obamacare because of my diabetes and it was difficult for my husband to find me insurance. It’s so nice to know that I won’t be denied again. I was worried that I would loose my doctor when we received Obamacare but that was not the case. We did have to pick a new dentist since our previous dentist was not on our new plan. But my husband and I are still getting the same great care that we received with our own insurance but now we are able to finally make ends meet.

    Posted by Jo |
  16. To Mel K… I live in Canada and every Province (State) has it’s own medical plan with a federal law governing minimal standards.

    Sure it doesn’t always work very well, but few people go into the poor house when they have major health problems. There are plans you can buy from private companies that add things (considerable) not covered by the public plans .

    In all fairness the US is the only major economy that doesn’t have a basic public health insurance plan. Perhaps the big problem in the US is the extreme passion there is to let private companies make health care the most expensive in the world. Which might be OK if the health care outcome statistics in the US were better — not exactly anywhere near the top of the list.

    Canada may have a public plan, but I resent those who resort to calling it communism. But yes it is a social plan covered by all tax payers. Perhaps one of the most common problems is that some people abuse it as they consider health care their god-given right and don’t consider the ever rising costs.

    Posted by JohnC |
  17. ObamaCare has hurt my health care options. I would like to see it repealed. I am on Medicare and some of the doctors no longer accept my insurance. ObamaCare has lowered the Medicare payments to Doctors in order to pay for others that may not be in this country legally or choose not to work.

    There is obviously some good to having more people insured, but the bad outweighs the good in my mind.

    Posted by John S |
  18. Insulin price has gone up due to ACA. Using it long term and paying addtl $12 every 3 months..another $50 even with insurance coverage from aetna..I could now see why seniors do not take their medication. They can’t afford it..Without insurance price for insulin must be rediculous. There will be more diabetics in coming years and insulin is important.

    Posted by Edward Albanese |
  19. I am pleased with the ACA provisions but I am from one of “those” states that has fought against Obamacare and has refused to allow its citizens to benefit from it. What so many people don’t realize is that they are blaming the wrong entity for their increased premiums and decreased care. Look to your state government - if they are actively blocking Obamacare - they are the problem!

    Posted by Julie |
  20. I don’t know if ACA has affected me. I’m on Medicare/Medicaid. Diabetes was just diagnosed 4 months ago. I got a free meter on line when told I was pre-diabetic and started improving diet but further testing showed I had crossed from pre to type 2. Medicare covers enough test strips for once a day testing. I test 6 times a day, sometimes less if skip lunch or am away from home and forget to take test supplies with me. I made a chart to track glucose levels and foods eaten, this had been a major help in improving diet. if I had only checked bs once a day would not have seen how foods affected it and improved as much as I have.

    Posted by angela hudson |
  21. I finally have medical because of obamacare. Insurance company do not like to cover people with pre excising condition. So I had to pay for everything myself. I nolonger have savings had to use it and credit cards to pay for my meds.
    So I am HAPPY about Obamacare I finally get to see a doctor and get help with paying for meds.

    Posted by Nancy |
  22. Where to begin… Since the ACA took effect, I have seen my premiums just about double (48%) for my health insurance. My copays have doubled for my diabetic medications and for my other chronic conditions, they have risen as much as 800%. I can’t afford to go to the doctor as often because those copays have risen, even if I could get an appointment. I don’t have dental or vision care under my plan, and now I can’t afford it. I worry a lot about my health. I worry more about my wife’s health, as her plan was deemed non-compliant. She will be losing her health coverage on June 15th. Her company is doing away with all health care coverage. We are very disappointed with this scheme that congress has dreamed up. It isn’t about care, and reducing the cost of medical bills; it’s strictly about selling worthless health care insurance, that isn’t worth the paper it is written on.

    Posted by Karl B. |
  23. Your comment on single payer shows me the level of misunderstanding you have. The difference is that you now pay for it in your taxes (or your deficit), not directly, so you tend to abuse it even more than if you have insurance.

    You should have learned something from the recent VA problems on single payer. My takeaway is that I don’t want the worst attributes of medical care, the DMV, and the Post Office combined in a program that is necessary to control of my diabetes.

    Posted by RK Smith |
  24. No improvements and has gotten worse.

    Posted by Ferne |
  25. I’ve occasionally had miracles in the past, and even composed a miracle album available on Reverbnation, but now I could die, soon, because I’m homebound, yet ObamaCare caused the only house call doctor on Oahu, who I still need, to leave private practice! The excessive number of visits demanded of me, now, by the new doctor, in order to care for diabetes, could be too many for my survival, because now there is only one doctor nearby who could take me! Some of these visits need to be by house call to ensure my survival, in my guarded, delicate, housebound condition. In addition, my husband has been forced home to care for me due to recent multiple re-injuries by new doctors and nurses unacquainted with my condiion reinjuring me, too close together, and then demanded a repeat of visits already handled in my history for which I had to make appointments I couldn’t survive in order to get my diabetes meds which I can’t go without, which reduces significantly my remaining chances of my survival!

    I am in a wheelchair with multiple conditions in which the original Rehab. doctor and other specialists have cautioned me to discontinue all but emergency doctor visits. The last three doctors have done so that I stayed alive tenuously following emergency medical transport by Delta Skywish for stem cell treatment to save my life.
    In April after having no way to be moved in March, I endangered my recovery by being required to see the doctor to get diabetes meds, at which time I obtained a Dr. note that I was incapacited and could not get a renewal on my state I.D.. The site to get them has been moved further away! Many doctors, even in Hawaii, have left practice so that the closest doctor is a mile away when I used to have doctors across the street here. I can’t move in order to live closer to the remaining doctors.
    I would be willing to pay 100% for a primary care physician to bypass the insurance requirement that I be seen in person in favor of a way to live by accepting some visits by videoconference. I sent the blood work into this doctor in March but demanded I be seen in April when it threatened my immediate future survival to have me come in because the nurse who came to my home for blood work injured both my arms so I couldn’t feed myself after I became housebound seeing the replacement doctor in December.
    I need a doctor who will give me just time enough to tell him/her that these exact issues were already handled with permanent history since 2011 with results showing a need to continue these diabetes meds, and that the proposed visit to a podiatrist is duplicative, unnecessary, and now life threatening, in order to give me back a chance to live after all! Instead it is demanded I come to three doctors in the next six months!
    I will have to break the appointments but will have unacceptable damage to my toes and eyes if I do, so that I won’t want to live knowing that even this will happen as it has before, despite a perfect A1C! I can’t find someone else! Is there a U.S. study to videoconference on occasion instead of a personal primary care visit that will take a patient that more than any other issue, sometimes NEEDS house calls, in order to get up to a survivable level and still treat diabetes?

    This is happening because Dr. Frank William’s site, , on Oahu, became defunct thanks to ObamaCare just after the ruling on ACA came down from the Supreme Court!

    Posted by Debra Piepgrass |
  26. The ACA is a net positive for our family with regard to Diabetes Type 2.

    We are on Medicare and have supplemental health and prescription plans in place.

    I hit the Medicare donut hole in mid year, but it’s manageable.

    Testing supplies are free or at very low expense. Laboratory work is done quarterly.

    I see an Endocrinologist quarterly, and a Ophthalmologist, cardiologist and a Hepatologist and Urologist each year. Doctor visits for wellness checks are also covered.

    I also have Supplemental Premium plans that cover Silver slipper exercise programs which helps with fitness and weight control.

    Posted by Mike Oberholtz |
  27. I am on Medicare. So have not had any experience with ACA. My supplemental insurance did raise their rates, but just a couple dollars a month. I can use any Dr. or medical facility that accepts Medicare. My complaints are about Medicare’s bidding for diabetic supplies. I was getting about 13 boxes of test strips delivered to my door, but now I get about 7 at the local pharmacy. I had been getting my insulin pump supplies from a pharmacy in Los Angeles (about 80 miles away). Now I get them from Mississippi!!! I have a CGM but since Medicare refuses to cover them I had to stop using it. I just can’t afford the ongoing expense. I really need the CGM as I have hypoglycemic unawareness, but they don’t care! When I first started using insulin back in the 1960’s I paid about $4.00 a vial, now Novolog is about $250 a vial.

    Posted by James McDowell |
  28. ACA has been the worse thing to come along.I think people should be able to get insurance but it should not be on the backs of others. I have been a Type 1 diabetic for 28 years now. I saw my insurance premium go up 33% because of this worthless act. My supplies have gone up as well. I just got my brand new pump at $2000 out of my pocket. Now the insurance company approved me to get the pump. I get a script for test strips and when I walk into the pharmacy they hand me this big bag. I’m like why such a big bag for three boxes of strips. They tell me that the insurance company will not cover my strips and they authorized this new meter and strips. I did not take them. I have a brand new meter integrated to my pump and is how I sync it with the computer. I am waiting for them to deny the sensors next for continuous glucose monitoring. I live very active life and am on the go almost 24/7. I do not need to have two meters to use and carry so I can link my meter for monitoring my treatment and getting better control. Luckily they have not chosen my doctors yet. I am sure that some people can benefit from this but I feel that most are not and are actually worse off than before it. I think that we will have more problems for diabetics than improvements through this act.
    I hope that this is repealed and a system that will work is implemented.If the American people will wake up and realize that the federal government is not suppose to have this much power then we will be better off otherwise we are doomed to being no better off than most 3rd world countries. Was health care broken yes but it was done by the insurance companies and then the well meaning liberals had to break it even more in the name of helping everyone but in essence they helped no one. Everyone will suffer because of it.

    Posted by Tim |
  29. My prescriptions went from $50 for a three month supply to $250. This is for my lantus and humalog each. So now I am spending $500 instead of $100. I am retired, so this is quite a jump for me. My husband’s insurance is what did this. They had until 2016 to change and they did it right away.

    Posted by Jan |
  30. This has been an awesome thing to have happen. For the first time in years I can actually get the medical care I need. I also have Celiac, High Blood Pressure, Diabetic Neuropathy, Anemia and severe migraines. I have not been to the eye doctor in over 5 years. If I could not get my medications I would not be able to walk and being able to go to the doctor regularly is such a relief….THANK YOU OBAMACARE!

    Posted by Cindy |
  31. “free preventive care”??? Nothing is free! Why do people still talk about the benefits of Obamacare as if there are so many good things about it. Just look at the VA and you can see what the future is.
    Millions have lost coverage because of a law that none read but voted along party lines. This is what all who voted for this inexperienced dope have foistered on the rest of the country.

    Posted by John D. Barbuto Sr. |
  32. I am on Medicare and age 72. I have no problems with the ACA but several observations.

    Before Medicare, ages 57 through 74, I had #10,000 annual insurance premiums, $3,200 prescription costs, $5,000 medical deductible, $1,000 disallowed medical cost by the insurance company, and $1,000 in other medical cost. By the time Medicare took affect, my retirement funds were gone. So I welcome Obama care. Too late for me but there for others now.

    I have notice that insulin costs have increased substantially. BCBS requires members to use Humulin which costs $68, whereas Novolin is only $38.

    You can still get a blood test monitor (color) free from One Touch, and other competitors also give free monitors.

    My doctor chose to retire so I had to get another. Many doctors, including my new doctor, chose to join one of the local hospitals and close their private practice. They have to get 1 patient every 15 minutes or the hospital drops them, so the quality of care has drop. Medicare went to 40% of billing for main items and zero % on tests and shots (I am on dialyses 3 times weekly).

    We have 5 republican senate candidates in SD. All appose Obama care. I would love to see a candidate that will work with the democrats to improve it.

    South Dakota is one of the states that refuse more Medicare so thousands here are still not covered by Health insurance. I pray that officials are elected that will change that.

    God bless

    Dennis Spencer
    Republicans For Obama Care

    Posted by Dennis Spencer |
  33. I had and was holding an A1C of 7.0 by adding Victoza to my treatment in the fall of 2012. I was approved in Sept of 2013 for another year of the drug. My insurance company required pre approval for this drug.

    This drug was no longer covered by my health insurance as of Jan 1, 2014. My May 2014 A1C has increased to 8.6. Alternatives are Byetta which I am not able to take due to being nauseas. The other option goes deep in the muscle & was not recommended by my doctor.

    Oh & my portion of the monthly healthcare premium went up $68.00 a month through my previous employers retirement plan.

    Obamacare did not help me at all!

    Posted by Beckie Kroeger |
  34. I have three prescriptions that would cost me over $300 each, I hit the doughnut hole. Can’t afford over a $1000 a month with other medicines and can’t find any program to help pay for them. So much for enjoying retirement.

    Posted by Richard |
  35. All I have seen as a person with type 1diabetes is doctors retiring, difficulty in finding qualified doctors to replace them, longer waits to see a doctor, increased deductibles on insurance, and a general feeling that the people who have paid for insurance have been had.

    Posted by Doyne Plummer |
  36. The benefits for me have far outweighed the negatives. The cost of my annual insurance (I’m retired and have had type 1 diabetes for 45 years) has decreased by more than $2,000 a year.
    I have already hit caps in some payments in the new law, and my most recent diabetes supplies have come at no cost.
    I can no longer be denied insurance or be charged ridiculous rates because no one wants me.
    The biggest negative my ACA insurance has is that it requires referrals which are a big time suck. But that is not part of the law, that is something the insurance company added in to make me less willing to see specialists when I need them. But I’m willing to invest my time to make sure I get the care I need.

    Posted by Bob Seltzer |
  37. I’m on medicare (71 yrs old) and had been getting testing supplies in the mail. That supplier is no longer approved. Wal-mart was listed as approved. When I 3 months supply of stips. I told them I have never had to pay since the day I was diagnosed.
    Had to show them again my Medicare card. They said they would run it through again. Still wanted over $400 for strips. While I was in there, (my 3rd trip) they called Medicare, and the person on the phone said I was “not qualified.” Wal-mart told me I would have to call Medicare and straighten it out. I called RRR Medicare and they were shocked that I wouldn’t be covered, but they said medical supplies and durable goods handled by regular Medicare. Called them — they said I would have to go through a mail order supplier in Florida.
    My doctor’s office faxed an order for supplies on
    three different dates (they called me each time the fax went through). The supplier kept telling me they weren’t getting it. It took from late February (starting with Wal-mart) until today (5/28) for any positive action to take place.
    The supplier in Florida calle3d today and said they have the order from my doctor, but it was
    dated April 14. I told them that was when she wrote a new order for them and they have faxed
    the same one over and over, wrting “2nd request,”
    “third”, etc on it. Anyway, although I still don’t have strips in my possession, they are supposedly “being processed” now.
    When I called this supplier, there is often a ten minute waiting time, and the recording offers you a call back. I have NEVER gotten a call back.
    I am not happy with this situation, and I’m thinkiing that in January when there is a new “low bidder” I will have to go through it all again.

    Posted by Brenda Johnson |
  38. To those who believe VA health care problems prove single payer wouldn’t work, I strongly disagree. The problem with the VA is that they are swamped by Iraq and Afghanistan vets with trauma and PTSD. They can’t keep up with the toll of the wars and occupations.

    That has nothing to do with single payer, which would greatly DECREASE the paperwork and limitations built into private insurance or ACA.

    Posted by David Spero RN |
  39. With Medicare changes, I hit the donut hole in June instead of September or October. My choices will probably be to decrease the dose of insulin I am taking or cut down on some bills. Obamacare is not the same cost for each state and Indiana is very high.

    Posted by Carolyn Adams |
  40. I have been a Certified Diabetes Educator(CDE) for 25 years. I have educated many people for free who could not get insurance because of their diabetes. It was unaffordable for those that could.
    Diabetes is a disease of self management. No one can manage it for you. That requires education which very few diabetics were getting from their primary care doctors, not only due to lack of time, but from lack of knowledge on the part of the medical team. It takes special training to understand and manage diabetes. That is where CDE’s are invaluable.
    No one should be saddled with the financial burden and fear of bankruptcy because of an illness.
    I find that many people who are speaking negatively against the AHCA are doing so from a political rather than a humanitarian stand.
    It’s about time we offer our citizens similar healthcare as does every other civilized nation.
    I am a careful driver who has never had an accident, yet I have to pay premiums to cover those who aren’t. That is just the way a civilized society works.
    Crystal H

    Posted by Crystal Harmon |
  41. Because of the ACA, my sister and brother, both employed with minimum wage jobs, are now with health care. My sister’s diabetes is being better controlled with more consistent medical appointments and her drugs are more cost efficient. This was quite a struggle for her before the ACA went into effect. My brother does not have diabetes but he does have high blood pressure. He does not have to decide whether to pay his energy bill or pay for his meds.

    Posted by Bev Braun |
  42. WITH ‘AFFORDABLE HEALTH CARE ACT’ LIFE HAS GOTTEN MORE DIFFICULT FOR MYSELF THAN EVER BEFORE. INSTEAD OF BEING ABLE TO RECEIVE ALL OF MY INSULIN PUMP AND BLOOD TESTING SUPPLIES FROM ONE SOURCE I NOW “HAVE TO” GET THE PUMP SUPPLIES FROM A COMPANY IN LOUISIANNA, MY INSULIN FROM A LOCAL SUPPLIER THAT HAS “AGREE’ED AT THIS TIME” TO DEAL WITH THE GOVERNMENT, AND FINALLY MY TEST STRIPS COME FROM FLORIDA - THE COMPANY THAT ORIGINALLY SUPPLIED “EVERYTHING”! AFTER FINDING THESE SUPPLIERS WHICH TOOK WEEKS DUE TO THE GOVERNMENTS LIST OF APPROVED SUPPLIERS WAS/IS SO OUT OF DATE AND THE PAPERWORK TO PROVE “I AM” A “BLIND, BRITTLE DIABETIC” NEARLY EXHAUSTED MY BODY AND TEMPER… I AM A RATHER HEALTHY BLIND, BRITTLE DIABETIC 50 YEAR OLD MALE WHO PUT UP WITH MORE UNKNOWING EMPLOYEES THAT WERE WORKING WITH / FOR ‘OBAMACARE’ & ENDED UP GETTING THE CORRECT INFO FROM COMPANIES THAT OPTED OUT OF WORKING WITH THE GOVERNMENT! THIS IS A PITIFUL SITUATION THAT DIDN’T NEED TO BE.

    Posted by DALE SCHOSEK |
  43. Costs on all items are much higher.

    Posted by John |
  44. I find myself in a donut hole,every new year,cannot get medication needed to survive,like my insulin,Humalog,& Lantus,I get plenty of supplies,but am refused Insulin to keep me alive,also cannot get pancreas so my foods that I eat can be digested,I had Pancreas cancer,now that I survived the Cancer,I’m going to die because of Obama care. I don’t know which way to turn at this writing,LOST!

    Posted by C.David Moore |
  45. C. David,

    Most insulin companies have patient assistance programs to help you stay on their product through the donut hole. I know Lantus and Humalog do. Look them up.

    Posted by David Spero RN |
  46. Personally the ACA has improved my health coverage at a reduced price. More significantly, my 21 year old perfectly healthy son suddenly had to have his gallbladder removed last month. If not for ACA, he would not have insurance coverage for this $25,000 hospital bill. He got the medical treatment he needed without us losing our home. I also have several friends in their 50’s who until this year could not afford insurance. They each went to the ER for treatment several times a year. Now they pay around $60 a month for insurance and receive regular treatment through a physician with a $25 co-pay. ACA is not perfect but at least it attempts to persue the ideal of “we take care of our own”.

    Posted by Tooserious |
  47. The things that help me the most.
    1) The most important thing I have is the silver sneakers benefit . Withe exercise and diet I am able to control my glucose levels.Daily.
    2) Being able to buy the best medication is paramount. I have to jump trough a few hoops but it is worth it.
    3) If i need a surgical procedure it wont break me.
    4) The insurance company staff try to make you feel ,your needs are first,they are under the microscope .5) The do nut hole is the only negative.Obama has stemmed the Dr and Hospital cost,but pharmaceuticals continue to raise cost .

    Posted by al balboni |
  48. By the way, do those of you on Medicare realize the dilemma on hospitalizations? If you need to be hospitalized be sure and ask if you are going to be in for observation or being admitted. If only for observation, Medicare will not pay and you have to pay the whole bill. Only if admitted will Medicare pay so be sure and ask and if they tell you just for observation go home and be willing to pay for the whole hosp. bill and you can guess how high that would be. Be informed.

    Posted by Ferne |
  49. ACA Mail-Order drug coverage overlooks the fact that insulin must be refrigerated. For retirees who travel extensively, the insulin can sit in the mailbox or on the doorstep for extended periods of time.
    Also the 90-day plan sounds great, but again, what happens when people who travel a lot and need medications and the medications are at home (delivered to home automatically to save money.
    The 90-day supply will also sit and wait for the recipients to return. Ordering a supply of drugs at a drug store (in a local area away from home), can be a “red tape bureaucratic nightmare.

    Posted by Nat Hubbard |
  50. Many of my medications have risen in price, including my Humolog insulin.

    Posted by Roger Beathard |
  51. I would like to see more coverage for needles to give one’s insuln. Thank ayou

    Posted by Elaine Griffon |
  52. I have talked to friends in England and Canada who have had medical procedures done and are very happy with the medical insurance they have in place. No worries about expenses, no long waits as we are brain washed into thinking. I know in Michigan we HAVE to buy a provision in our car insurance and pay for people who don’t have car insurnace. They buy insurance just to get the plates/tabs and then cancel the insurance. I wish they have an Obamacare for car insurance

    Posted by Steve P |
  53. I am 57 and have been a diabetic for 14 years with a family history on both sides. From the very start once I was diagnosed and started on oral medication my diabetes has been controlled. My A1C has been below 7 and usually runs 5.5 – 6.0. As my husband is on SS Disability (for a mental illness) I qualified for Patient Assistance to pay for my medications. However I was not able to test my blood as often as I should as no one has a program to assist you with meters and test strips. I can get all the meters for free but nothing to help pay for the strips. Bayer sent me a new meter and a card so I only paid a maximum amount a month for test strips. However, this offer is not valid unless you have insurance.

    I am overall very healthy so my medical expenses were low compared to others. I applied to Medicaid and was instructed that due to my husband’s disability, we had to spend over $600 a month out of pocket expenses before Medicaid would kick in. We still do not pay $600 a month for medical expenses. I was uninsurable. In 2007 husband qualified for Medicare and our out of pocket medical expenses went down even more. I reapply to Medicaid every year and every year the amount goes up on the out of pocket expenses but is higher than the cost of living raise received from Social Security. But since my medication was being paid through Patient Assistance and there is a clinic that has a sliding scale to pay for doctors visits so my medical conditions have been monitored by a doctor, I was doing very well. My oral medication had a generic available so I was no longer eligible for Patient Assistance. The generic costs over $200 a month now, but started out at $300 a month. Bayer sent me a new meter and a card so I only paid a maximum amount for test strips. However, this offer is only valid if you have insurance.
    I was excited when ObamaCare was passed and I would be able to get some assistance to pay for insurance. I had trouble applying due to the online issues but eventually got through and according to the website I qualified for assistance but I had to call to see what the options were. After speaking with one of the agents, I do not qualify for assistance, but they could offer me a policy for $450 a month with a $5,000 out of pocket annual expenses and co pays for doctor visits and lab work. Of course Missouri did not expand the Medicaid program, so I still was not able to get insurance or Medicaid and with ObamaCare going into effect the sliding scale is no longer available. The state and federal programs have been discontinued due to funding being cut because everyone is eligible for insurance.

    Now I do not receive discounted fees for doctor and lab visits, my medications are increasing in cost and the number I am taking since I am not receiving medical assistance for my diabetes things are getting out of control. I receive none of the benefits that were promised and I have had to decide what’s more important this month: heating/ac, food, gas to get to appointments or medication.

    Posted by Sharon L from Missouri |
  54. Not pleased with Obamacare!!!

    I am a Type One Diabetic. Type One Diabetics are the minority type of Diabetic. Type One Diabetics continue to face discrimination even if we have A1C readings of 6.0 (it is assumed you don’t control bloods sugar).

    The Insurance company continues to dictate how many test strips one can have and how many needles one can have. Type One diabetics are dependent on their insulin and needles as a daily way for survival.

    I must continue to pay out-of-pocket for enough needles and supplies.

    In addition, I am finding billing to have gotten more insane. Now, the doctors’ all must state that my health conditions are connected to a pre-existing condition of Diabetes or the insurance will expect me to pay 100% of the bill.

    I give this Obamacare two thumbs down!!!
    P.S. If someone is 75 years old (or older), the Obamacare plan does not intend to help them with major medical issues (just let them die or feed them to the polar bears or vultures). Time to vote these crazy lawmakers out of office. Remember, they don’t use Obamacare. They get healthcare benefits for life which are not part of this dumb plan.

    Posted by LindaMeadowlark |
  55. I believe the enormous cost increase of insulins is not related to the ACA. I feel it is simple straight-forward price gouging by medication suppliers — middlemen primarily.
    If I am wrong, please someone set me straight on this matter.

    Posted by Jacquelyn Kelley |
  56. My nutrition doc has opted out of Medicare because she does not agree with what the government requires her to do for reimbursement.
    Therefore single payer is not a good idea. The nutrition treatment I am getting is superior to what Medicare would provide.

    Posted by don |
  57. I am a type 2 diabetic, and my insulin went up so drastically I can barley afford it. It went up from $10.00 to 157.00.

    Posted by Letha |
  58. My wife is on byetta ($400 a month) and novalog (roughly $60 month).

    Will or will not any aka plans pay for this?

    I thought id start by asking people in the know since all this info seems to be hard to get.

    Thanks.

    Posted by rdasle |
  59. Hi rdasle,

    Best to ask your pharmacist about the coverage under different plans. He or she should know.

    David

    Posted by David Spero RN |
  60. In June I got my prescribed 10 test strips per day which equals 300/month. I’m a type 1 diabetic and I test my blood sugar 8-12 times per day because I’m active (I run marathons) and I drive a company car and do NOT want to go low and get in a car accident. So to protect my employer from liability I perform multiple blood sugar checks.

    On July 19th I find out that I am now limited to 6 test strips per day! Because of the ACA!! My pharmacist and I are getting a medical pre authorization in process to get me my 10 strips per day but this does not bode well for type 1 diabetics. In order to get an insulin pump, which IS the standard of care for type 1 diabetics, you MUST demonstrate a commitment to your own diabetes care and one of the measures the doctors use is that you check you blood sugars 8-12 times per day to QUALIFY for the insulin pump.

    Get the government OUT of my way. I will manage my diabetes with my doctor’s and the diabetic communities help. I DO NOT NEED THE GOVERNMENTS HELP!!! My A1C’s have been under 7 every time but ONE in the last 17 years since I was diagnosed!

    Thank you for your time.

    Posted by Robert Wilson |
  61. Interesting Article, it proposes that single payer (Medicare) will alleviate the financial burden:”For millions who don’t use health care, whether because they are healthy or because they can’t afford it, ACA adds a financial burden they don’t want. That’s why single-payer coverage like Medicare would be so much better.”

    It will merely tranfer the burden to the TAXPAYER!

    When you hear Single Payer, you should HEAR VA Health Care, and look at the stories that are in the news: Waiting lists, waiting lists shredded to make bureacrats look good, etc.

    The Affordable Care Act is headed toward Medicare and The Veteran Affairs Health System,

    we will have waiting lists, prescriptions not on the approved list (or not available at all).
    Abortions and Hospice will be covered, while Treatmenets that extend life will be viewed through the prism of cost /benefits to the collective.

    The Elite, think Senators and Congressman, will have their own Health system, with unlimited care; also paid for by TaxPayers.

    Posted by Ben j amin |
  62. This “affordable healthcare act” has ruined my financial life and made it a general nightmare. I have had type-1 for 16 years, and been on a pump for 15 of those. Never have I had an issue with getting supplies or co-pays being ridiculous etc. My normal 90 day supply of Humalog (for which there is no generic) was 4 vials and I paid a $20 co-pay. Very reasonable. My last visit to the pharmacy, the same one Ive used for 16 years, I was informed that my insulin was over $800. I called the insurance company and they informed me that the price increase was due to me not using “their” pharmacy online and having it shipped to my house. Ok, so I called and arranged the prescription transfer and delivery etc. I was then informed that they only ship 12 vials at a time instead of my regular 4. I was then asked how I would be paying the $1,753.12 that it would now cost me for the only drug I need to stay alive. Mind you, this is not for my dr visits, which aren’t covered, or testing supplies or pump supplies, this is just the insulin. My “affordable” deductible that I have to reach before they cover anything is $2,500. Which I will not reach before it resets next year, so essentially I am paying money for insurance that does not now nor will it cover anything for me. So why not just cancel it you ask?? Bc “president” obama has outright ignored the constitution yet again by confiscating my tax return if I do. The irony in this situation? I am a paramedic. I am the one who has to tote these misinformed, ignorant, system abusers to the hospital 5 times a week with absolutely no medical complaint. They use our ambulances to get around town. You call 911 and go to the hospital for a legitimate illness, the ride alone will cost you $1500.But for someone who collects medicare/Medicaid (which I pay for but don’t qualify for btw) calls 911 every day for no reason at all, it is 100% free. Wake up people!! Our country is in so much trouble it’s unreal.

    Posted by jon |

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