Obamacare and Diabetes — Year Two

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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  • William Boling

    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

  • Rose

    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…

  • Donna C

    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.

  • Jessica

    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.

  • Lisa

    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.

  • Lin

    So far, all is great! Thank you!

  • free

    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.

  • Jeff Jansen

    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.

  • Rob Gerster

    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.

  • Kimberly Monaghan

    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.

  • Mel K

    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?

  • littledipz

    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.

  • meredith

    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.

  • Christy

    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.

  • Jo

    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.

  • JohnC

    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.

  • John S

    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.

  • Edward Albanese

    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.

  • Julie

    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!

  • angela hudson

    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.

  • Nancy

    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.

  • Karl B.

    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.

  • RK Smith

    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.

  • Ferne

    No improvements and has gotten worse.

  • Debra Piepgrass

    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, http://www.thehousecallmd.com, on Oahu, became defunct thanks to ObamaCare just after the ruling on ACA came down from the Supreme Court!

  • Mike Oberholtz

    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.

  • James McDowell

    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.

  • Tim

    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.

    • misatokatsuragi


  • Jan

    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.

  • Cindy

    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!

  • John D. Barbuto Sr.

    “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.

  • Dennis Spencer

    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

  • Beckie Kroeger

    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!

  • Richard

    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.

  • Doyne Plummer

    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.

  • Bob Seltzer

    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.

  • Brenda Johnson

    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.

  • David Spero RN

    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.

  • Carolyn Adams

    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.

  • Crystal Harmon

    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

    • misatokatsuragi

      “I find that many people who are speaking negatively against the AHCA are doing so from a political rather than a humanitarian stand.”

      From what I have read, most of these comments are not made from a political stand, but from a practical experience stand that these people have been experiencing since Obamacare took effect, and I think it is highly arrogant of you to label those who criticize Obamacare because of the negative effects it has had on their lives, as being people who only have a political spin as their agenda for posting about the effects that Obamacare has had on them.

  • Bev Braun

    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.



  • John

    Costs on all items are much higher.

  • C.David Moore

    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!

  • David Spero RN

    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.

  • Tooserious

    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”.

    • misatokatsuragi

      “ACA is not perfect but at least it attempts to persue the ideal of “we take care of our own”.”

      Not really. The ACA was never about health care. It’s was and still is, about bankrupting the middle class.

      • Pam Dundon

        No, it’s the insurance companies who are doing that, the law unfortunately was written with them in mind since there was no chance to pass any kind of universal health care like the rest of the civilized world has and which works fine for them.

  • al balboni

    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 .

  • Ferne

    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.

  • Nat Hubbard

    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.

  • Roger Beathard

    Many of my medications have risen in price, including my Humolog insulin.

  • Elaine Griffon

    I would like to see more coverage for needles to give one’s insuln. Thank ayou

  • Steve P

    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

  • Sharon L from Missouri

    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.

  • LindaMeadowlark

    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.

  • Jacquelyn Kelley

    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.

  • don

    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.

  • Letha

    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.

  • rdasle

    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.


  • David Spero RN

    Hi rdasle,

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


  • Robert Wilson

    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.

  • Ben j amin

    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.

  • jon

    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.

  • James

    I’ve been a Type I diabetic since I was 5. I’m sure my parents struggled every month to afford my medications, but I never went without. I grew up healthy with few problems and have always kept my diabetes in check. I’m healthy, in good shape, and my blood sugars have been under good control. Until this year. Now my prescription copay that was $30 for a month’s supply of one of my insulins has jumped to $376. My second insulin; which also used to be $30/month, has jumped to $480. Now I’m a licensed professional architect. I earn about the middle of the bell curve for my industry. I used to live in a 1,200 square foot house. That’s since been foreclosed on. I now rent a house close to the same size, but I make more now than I did a year ago. The problem is, I don’t make 10 times more. I’m going broker and broker every month just trying to stay alive and healthy. I don’t have Type 2 diabetes. I didn’t choose to be diabetic by eating poorly or not exercising. Yet for the first time in 33 years, I can’t afford my medication. My A1C is through the roof. I’m exhausted all the time. I can’t focus. I’m having horrible migraines related to high blood sugar and dehydration. I’ve tried contacting Lily and BD and Novo Nordisk about some financial help with the medications I need to stay alive. But to no avail. Since I have Coventry insurance (which my employer pays for 100%) I can’t get any additional coverage or benefits. Bear in mind that Coventry has no Insulins in their first tier. And those in their second tier are outdated, practically obsolete and still cost me ten times what I used to pay. Until my deductible is met, I can’t dream of being near as healthy as I’ve been the past 33 years of my life. So I’d like to thank Coventry insurance, the Federal Government and many and various pharmaceutical companies for assuring that my best years are now behind me. If anyone has any information that they might be able to pass along to me that might help my situation, I’d be so happy to hear it.

    • AudreyA

      James, I hope you are signed up to get track-backs so get this response. While the rest of the US catches up to the farce this Obama care is, maybe you should move to Canada. I’m not kidding…as a skilled professional, you might get in more easily.

  • JFer

    I have always had trouble with health insurance companies allowing more than 200 strips per month. United Healthcare was the worst. I was diagnosed with Type 1 in 1981. My A1C is usually around 5.5 and I have no other issues. I was still denied when I applied for private insurance. There are many times where I had to pay premium prices for my strips and my insulin because the insurance company refused to allow more than what they felt was necessary. I recently had to take a job that did not provide health insurance. I switched to Obamacare and now pay a premium of 250 per month with insulin co-pays of 15 and 20 dollars a month. If take into consideration that my Lantus and Humolog would cost me over 650 per month (I was denied their patient assistance programs because I make a little over the poverty level), I am very appreciative of the new health laws. I realize that they have their flaws, but I did a lot of research and discovered a plan that was affordable for me. The alternative of paying out of pocket for the crazy prices that Lantus, Humolog and One Touch charge was not an option. I have kept all of my same doctors also.

  • Dynawos

    The ACA has been a disaster for our household. We pay BXBSM over $1800 A MONTH for our “premium” plan. Our ages are 65 and 74. We’re now paying for kids to stay insured on Mommy’s plan until age 26. We’re now paying for Pre-natal care, Vision and Dental for Kids. Why the hell am I paying for these PERKS that we’ll never use???
    Our Co pay on Drugs went from $5 to $20 each for generic for 90 days, from $20 to $110 for tier 2 drugs and from $80 to $230 for Tier 3 Drugs.
    We NO LONGER are covered for testing strips or syringe needles like we were before. What is my $1800+ a month buying……..nothing but headaches and denials of benefits we were previously covered for.
    ACA is wonderful for those who are receiving Medicaid. They get 100% coverage and don’t pay a dime. We, on the other hand, have huge deductibles & huge co pays, limitations of the choice of hospitals and doctors
    and out right denial of coverage, I hope in 2016, Republicans can get this Obamination repealed.
    I cant imagine what our premiums will be next year. This “act” is ANYTHING but “Affordable” for us.

  • Debi

    It’s open enrollment time at my husband’s employer, who has provided decent insurance for years… until now – especially for our Diabetic daughter.

    Now, we’re trying to figure out what we’re going to eliminate from our budget/lives (food?) so we can afford our daughter’s necessary, NOW VERY EXPENSIVE, Diabetes supplies.
    And that’s before we even start thinking about how we’re going to pay for my expensive [“Biologic”] meds for my Crohn’s Disease.

    Thanks a lot, Obama 🙁

  • Monica Oldham Fawson

    My frustration is that I am paying double what my insurance used to be and the coverage of my humalog and test strips are basically worthless to me. I used to get humalog (3 viles) for just $10… same for test strips. Now it costs me $500 for the basics. I could get an insurance plan that would cover better but it would cost about that much more. I can’t afford either so I am basically forced to get the very basic insulin at Wal-Mart that you can get over the counter for $25 a vile. It doesn’t work as well, but what can you do? And as for my pump supplies, well, it’s cheaper for me to order from a discount supplier and pay out of pocket than to go through my insurance. Tell me again how any of this is good for diabetics?

    • Garrett Duell

      Yeah, Obama talks alot about middle-class economics, and building a strong middle class, but Obamacare has minimal effects in the rich, and the poor are getting subsidized, so this really only HURTS the middle class. It is a tax on the middle class. And, as a diabetic, I am getting the short end of the stick, and I too will have to switch to a much more unstable(crappier) insulin. Really ridiculous…

  • metaluna

    Debi, the same thing has happened to me. I’m a Type 1 for 48 years and now I can’t afford my insulins or BG strips. Our co-pays used to be $20 (along with appointments) then went up to $50 a few years ago. Now they’re $70 each! I can’t afford these prices and I’m mad that I have increases so that others can have coverage. I work very hard and so does my husband. We and others didn’t deserve this. Yeah, thanks Obama and it is NOT affordable health care now!!!

  • Team Type 1

    Florida Blue decided as of January 1 to remove humalog from it’s covered insulins. It will not be covered at all, not even with preauthorization. My husband is a type1 diabetic who has been using Humalog for 20years. As of Jan 2014 he was eligible for a private plan due to the ACA, and now after 1 year on the plan,he is being told his insulin won’t be covered this year without any notification. I had to find out when I went to fill his prescription this month. One would think that they would at least send us a new policy form for this year prior to Jan 1! I sell insurance in Florida and I am very unhappy with what the insurance companies have been allowed/had to decide to do since the ACA was passed.

  • Paige

    I am a Type 1 diabetic and this article is completely inadequate in covering the needs of the Type 1 diabetic under the ACA. Type 1 diabetics will actually die if they don’t have insulin for 3 days, so delays in supply are potentially life-threatening. Type 1 diabetics also need a regular supply of pump equipment or syringes, which fall into the category of Durable Medical Equipment (DME). Any delay in receiving these supplies is also potentially life-threatening.

    TYPE 1 DIABETICS, what has YOUR experience been under the ACA?

    • Type I diabetic

      I have lost my insurance (from turning 26) and have been hoarding any medical supplies I can come across. I’m one of those individuals who “fall through,” that hole. The hole where if you make under $11,490.00 (Poverty line in VA) you are not able to get subsidies or financial assistance for medical coverage. There is also the fact that only if you are having babies then you are able to get medicaid. So I do not have medicaid, or insurance, because I cannot afford it. I do at least go to the New Horizons Health Care facility, but they are mostly able to handle type II cases, not type I.

      I wish the gov’t would wake up and see that we need these things to live while the so called, “ACA” is murder to millions of us who are unable to come across the supplies we need! I only have about four more insertion kits before I have to give up my pump. I get the feeling that the government wants to kill off those who have chronic conditions which can become terminal without the proper supplies that are needed. If you are reading this Virginia…HELP I dont want to die, and I dont want to become blind/deaf/limbless/depressed/unhappy/DEAD! I love art and slowly my eyes have been failing me, my feet are slowly becoming numb and I’m becoming quite depressed. lol can I hire someone’s kids so I can get insurance, so I can finally live the way I want? What happened to Life, Liberty and the pursuit of happiness? I’m definitely not happy and it’s ruining my life!

      • Terry Wilcox

        Had your state expanded Medicaid you be covered and your strips would be covered. I would suggest voting local to elect a person that would fight for you healthcare even though you make so little. I feel sorry for people who live in red states that don’t offer subsidies or medicaid to those who for some readonly don’t make more than $14,000. I had insurance for two years through the exchange and worked full time. Then I was diagnosed with Hodgkins Lymphoma, thankfully my plan was reasonable and I got the care I needed but that year I barely worked so come re-enrollment I still had no income so I didn’t qualify but I would have qualified for Medicaid in over 24 other States and continued with insurance until I was employed or until next enrollment period. Either way, these states that don’t offer coverage for folks not reaching that $14,500 for whatever reason, is leaving us in the cold. Just know that testing strips and insulin is covered by Medicade and Medicare. I hope you’re in good health. Namaste.

  • Kris Roth

    Kris Roth I have to share with all of you THIS INSURANCE is a scam for all of us diabetics. Have been under great control on pump for too many years to remember. My insurance was canceled and the policy I ended up with (because it was the only one I could afford) pays for nothing. The only affordable insurance there is is for someone who sits on their butts and does nothing!!!!!!!!

  • joe

    I am bipolar and my A1c Is about 10.9 the insurance company won’t allow the mentally ill to have the insulin pump and I don’t even think they allow the mentally ill to have novolog because they’re afraid they won’t pay attention.

  • jon

    There seems to be a lot of stories here about insurance companies covering less and having diabetics pay gor it with not only their money, but also their health. I have been type 1 for 20 years and until recently have enjoyed the benefits of fantastic scientific break throughs in diabetes control options, from the omnipod to dexcom to many diffrent insulin choices. But now i am starting to see that unless you make a certain amount of money in this country scientific breakthroughs are not for you. Do we not have any legal recourse? How do we even begin to address the continuing unfair practices of insurance companies? I wish the american diabetes association and jdrf would do more to support a growing population of people loosing out to insurance companies and going broke despite how hard they work. Do they even know how hard it is to work yourself to exaustion with diabetes, or to even deal with it by itself is diffecult. If there are any ideas on how to fight back, i would love to hear them. My doctor is giving up on helping me take advantage of the best medical treatments and it seems like everyone else is giving up on me as well. I would love to be more then just a dollar amount, and for the directions of my doctor to be followed by my insurance company. Screw you united health, we know what your ceos make and we know what how much more every year you charge us, and for what. You just dont get what you pay for anymore.

    • Suzy Gowen Cervin

      Yes, I wish there were more advocacy from out advocacy organizations on making the daunting challenge og staying alive more affordable for people living with Type 1. So many people could benefit from CGMs yet so many people have no chance of ever affording one.

      • Amelia Botello

        what do we do? The more I see on these blogs and comments and stuff when I’m trying to find answers to questions only I’m asking in my circle. It’s like only we know wow but we’re forced to cope and manage so it’s like damn if we can take the diabetes on why don’t we have stuff together somethings up yes idk where to start.

  • ArtsyDiabeticIGirl

    Yeah I know this is an old article but I have to vent somewhere!

    I have lost my insurance (from turning 26) and have been hoarding any
    medical supplies I can come across. I’m one of those individuals who
    “fall through,” that hole. The hole where if you make under $11,490.00
    (Poverty line in VA) you are not able to get subsidies or financial
    assistance for medical coverage. There is also the fact that only if
    you are having babies then you are able to get medicaid. So I do not
    have medicaid, or insurance because I cannot afford it. I do at least
    go to the New Horizons Health Care facility, but they are mostly able to
    handle type II cases, not type I. I also do not have to pay the uninsured fee during tax time.

    I wish the
    gov’t would wake up and see that we need these things to live while the
    so called, “ACA” act is murder to millions of us who are unable to come
    across the supplies we need! I only have about four more insertion kits
    before I have to give up my pump. I get the feeling that the
    government wants to kill off those who have chronic conditions which can
    become terminal without the proper supplies that are needed. If you
    are reading this Virginia…HELP I dont want to die, and I dont want to
    become blind/deaf/limbless/depressed/unhappy/DEAD! I love art and slowly my eyes have been failing me, my feet are slowly becoming numb and finding it harder to move. I’m becoming quite depressed. I can’t and won’t let it defeat me but…
    lol can I hire someone’s kids/babies so I can get insurance, so I can finally
    live the way I want, and become an RN (since they keep changing how FA/tuition works this is slipping away as well)? What happened to Life, Liberty and the pursuit of
    happiness? I’m definitely not happy and it’s ruining my life!

  • Doug Deiterman

    I supported the ACA however I was very wrong. I have always had health insurance but the premiums have continued to increase and the coverage continues to decrease. We pay more and get less. I felt that something had to be done but ACA made things worse.
    It was obviously designed by bureaucrats with the intent of lining the pockets of insurance companies and healthcare providers.
    Healthcare coverage does not begin to cover the cost of managing a chronic health condition such as diabetes. My employer provides Blue Cross Blue Shield but I cannot afford visits to the doctor, recommended lab work, and I go without medication.
    ACA does mandate that certain preventative screenings be covered. Why bother? Why screen for conditions that you can’t afford to treat.
    ACA has been a big disappointment. I realize government is ill-equipped to solve the problems with health care. I now support removing healthcare and social programs from government control.

  • DBrown

    I had ‘caddilac’ insurance through my employers before the ACA. It paid for everything except some copays. Needless to say, I lost it with the ACA. Now I pay just as much premiums, but have deductibles plus copays AND I don’t have even close to the same coverage. At first, Blue Cross Blue Shield paid for my Metformin, Byetta, Levimire and Novolog. Then the second year they decided that they would no longer pay for my Byetta or any other medication like that, with the excuse that ‘it’s not recommended with short acting insulin’. Never mind that I had been taking it with short acting insulin for over 5 years with no side effects. I had lost 75 pounds and my sugars were in check. A1c’s were doing good. THen they said no more Byetta, but allowed me to have Bydureon (same thing but long acting), then they decided I couldn’t have that either. So now, I’m taking 4 times the insulin I use to have to take (no savings for them), AND I’m gaining weight like a pig. I’m back up to 280. I feel horrible and want to eat constantly. my doctor put me on Invokana along with all this other stuff. Still doesn’t control my blood sugars. The amount of money these insurance companies are losing because of this pitiful ACA is making them cut back on patients care, My out of pocket on my medical care is over 10k a year now, and I’m losing control of my health because of their restrictions. Insurance companies are overriding our doctors. I don’t like that the government has indirectly taken control of my health and makes my health decisions instead of my doctor.

    • K Narmer

      In the very unlikely event that ACA had anything to do with your employer’s decision to go to a higher deductible/co-pay policy, and/or making you pay a bigger part of the premium, have you checked out other insurance providers where you live? I am constantly being told by clients and family members that they “have” to get their policies from their current or former employer, which is absolutely not true (although depending on where you live, other choices can be sparse or no better). In many cases, they may do much better with a different company, even if not necessarily able to keep the same doctors. The ACA guarantees you can get new coverage with a pre-existing condition, new in many states.

      I can’t speak to your state, but in mine (NY) the high deductible policies are equivalent in combined cost to the higher premium, low or no deductible policies IF you use up the deductible. High deductible policies can be great for people in good health with no unforeseen medical events, but certainly not for someone in your situation. I personally avoid them for exactly that reason, because I know I will be spending the deductibles very quickly. My husband has a high deductible plan that has worked out very well for him.

      If you haven’t already compared all the policies available to you where you live, please consider it. There are often independent brokers who will do it for you if it is too confusing: it is a pain, especially the first time. Time MAY be running short for you to change for 2017, however, so you need to get right on it.

      I think the ACA needs further adjustment as experience will dictate, and am not an apologist for it. On the other hand, It is very convenient for employers, insurance companies and others to blame the ACA for making decisions (higher premiums paid by you for less coverage) in their own best interests, not their employees or customers interests. ACA has nothing to do with your employer provided coverage, Medicare or Medicaid. Yes, the companies in the state exchanges haven’t seen as many healthy young people sign up as hoped and more chronically sick people who couldn’t get insurance before are getting it now, but those facts don’t impact the insurance companies that are not in the exchanges. And most people who use the ACA state exchanges for their coverage get some or most of the premium subsidized, so you need to check that out while sorting out what company might be better for you. (Fades out at about $97K income for a family of four).

      I totally agree that your situation is disgusting, but I also know that most of the self-serving insurance company PR is simply not true.

      Lastly, when I challenge an insurance company on a decision overriding my doctor they have always folded (5-6 times) rather than pay for lawyers to get involved. I share your anger because of the stupidity of the limits on my supplies and some of my prescriptions, but that isn’t new or the ACA. Did you know the profit BCBS company that owns all the not for profit ones has annual profits of about half a trillion dollars? While cutting insurance coverage for its employees, pushing high deductible plans on them and paying 200+ “vice presidents” over $250K per year and holding company “conferences” in Hawaii?

      I hope this all works out much better for you in both the short and long term. Good Luck!

  • Suzy Gowen Cervin

    I wonder if there are any legal protections that will now stop companies from putting a cap on how many test strips a month that a doctor orders. For people with Type 1, needing to do a BG 10x a day is not unheard of, yet man insurance companies refuse to cover more than 200 strips a month, even if the doctor’s prescription orders 10 checks a day. Is this legal for insurance companies to do? How can they deny test strips to people with Type 1 whose doctor is telling them to check 10x a day?

    • Jan Goenner

      I totally agree! I have to have my endo write a letter to Insurance company (BCBS-MN) so that they will cover 10 strips a day, otherwise insurance will only pay for 6.8-where does the other .2 test strip go? 6.8 X 30 is 204 strips-pharmacies sell strips in boxes of 25, 50 or 100, where does the 4 strips go? If the insurance co. agrees to the exception # from my endo, then that only lasts for a year, then I have to resubmit a letter the next year. The stress and cost for a Type 1 is just never ending. Like I chose to not make my own insulin? Jan

  • Ben

    It’s a joke. Insulin isn’t covered. We’re left to die by imsurers like we were before.

  • Sonia

    frustrating that the deduction for Insulin is super expensive and for those middle class who can’t afford it! I get Health Insurance through work so I don’t qualify for any programs offered by ObamaCare, so I’m left with no choice but to pay the high prices…

  • lobotomy101

    Get rid of that person in the white house. Put someone in who cares about this country, and hope he can get rid of this illegal Barry care. My daughter is dealing with the same problem, can’t get enough strips to last a month. Always has to go back and forth between doctors and pharmacy and insurance for days to get anything done on a monthly basis. I lost my free insurance through my employer. I am furious for what that person in the Whitehouse has done to this country. Sure I was able to refinance my house and take 250 off the payment. On the other hand I now pay 500 a month for Healthcare, so I’m not a fan. I am very worried for her. On top of that it was confirmed by two Italian doctors from the social security administration that her early onset diabetes was caused by a reaction from the mumps/rubella vaccine. She was healthy before. Not overweight no junk food. It was caused by forced immunization so she could go to school.

  • Linda

    We are now on a payment plan to pay back the total amt. of our subsidy (6,000.00). Being on a fixed income, it has been a strain. Now I find I’m in the donut hole and the cost of my 2 insulins are so high I can’t afford them. In addition, my ins. Is dropping one of my insulins!

  • Julie McRoberts

    My dad is 96yrs. old. Type 2 diabetic. He has been on 2 insulin. Both. long term 24 hrs. and 1 short
    term.,My dad has to pay entire co-pay? on pens why? This just changed.Medicaid is discriminating
    against people with this type of disability..Where do you go to file complaint ?