How much do you pay out of pocket?

[ROVERT81402]

My husband and I were talking last night about this. We have super great ins. right now, but we're worried when Trevor gets older, and has to get his own ins., how much it is going to cost him.

[OSUMom]

So are you talking about monthly for our family of 4 just to have health insurance?

[frizzyrazzy]

ok, editing because I read the question wrong, but we pay 0 for pumping supplies and $3 a month for test strips and $3 a month for insulin. That's all I pay.

[ROVERT81402]

So are you talking about monthly for our family of 4 just to have health insurance?

How much you have to pay out of pocket for D supplies. Sorry, I should have worded that better :o

[BrendaK]

I feel SO blessed that we have never paid a dime for D supplies. When we lived in Michigan, we had Children's Special Health Care Services that covered what our regular insurance didn't.

Then we moved to Illinois -- they do not have CSHCS, but A+ medical accepts our new insurance. So we don't have to pay any copays since we use A+.

Now health insurance premiums, that's a different story. We pay $425/month for a family of 4. We chose the more expensive insurance because they did not have a cap on DME and because A+ accepted it. A+ did not accept the cheaper option, the HMO and the HMO only paid for 50% of DME and it had a cap.

[OSUMom]

How much you have to pay out of pocket for D supplies. Sorry, I should have worded that better :o

No problem. :) This could take me awhile to figure out though. We just quit APlus Medical.

We're probably over $100 a month if you want me to get specific. :)

[buggle]

Is the poll per month or per year?

We pay all out-of-pocket until we reach our deductible. We have high deductible, but supplies are so expensive that we should max it pretty fast. We've only been dealing with D for a few months and our deductible was already met, due to a really, really bad year for our entire family. Even once we max the deductible, we still have to pay 15% for insulin, strips and syringes. So then, it's still between $100-200/mo. I stocked up on insulin since our deductible resets next month. But if we have to buy everything pre-deductible, it'd be over $500/mo. That's not including doctor's appointments and labs. Our diabetes center billed $800 for each of the initial visits -- think it was the first 3.

It's an expensive disease.

[liasmommy2000]

I have a $14 copay for glucagon kits. We choose to pay out of pocket for Skin Tac wipes as our insurance won't cover them, just regular IV prep etc and Skin Tac works SO much better.

Everything else is covered 100% with no copays.

We are very lucky, the health insurance is the only reason I drag myself out of bed and to work these days, because with the cost of gas and everything else going on in my life, it really isn't worth the salary any more. :rolleyes:

[albasmom]

I don't have this problem as the system in Denmark is very different. Just wanted to say that i admire you for being able to deal with all the insurance issues on top of everything else. I think that is amazing :)

[jacobandhannah]

Jacob's Omnipod is where most of our expense comes in. We have to pay 20% on it. I get his test strips for $15 a month through the frestyle promis program. My sister works at a doctors office and the Novolog drug rep gives her bottle of insulin for us. The last time he came he gave her 10 vials. That has been a lifesaver.

[NicksMother]

We're very fortunate that my husband has excellent health insurance. At this point, we are only paying an $18.00 co-pay for each re-fill on Lantus, Humolog and Glucagon. Endo visit co-pays are $50.00. All test strips and pen needles are covered at 100%.

In Pennsylvania, kids with D are eligible for Medicaid because of their disability and they have no income. Once all the paperwork is completed, all the costs that are not covered by our insurance will be covered by medicaid.

[Jacob'sDad]

We pay a copay on the insulin but that's it. It probably works out to about $20 a month.

[jscat]

Diabetes supplies are covered 100% by dh's health insurance. We are Canadian and have Universal Healthcare that covers doctor's, hospitals etc...

[Mom2rh]

We buy our own insurance (dh is retired/self-employed) which costs over $5000 a year for all of us. We have a high deductible plan...so we pay $4800 out of pocket before anything is paid for by insurance. Then we have another $1000 out of pocket before stuff is paid 100%. We have reached that already this year because of Ryan's tonsil surgery. Woot.

[wendyc]

We pay $0 for durable medical goods which are pump supplies. They do not cover preps or adhesives, but Animas gives us a discount on those. We pay $10 for insulin, strips, lancets and glucagon.

We are very lucky!

[Mermaid]

We pay $4000 before anything is covered and then there is a cap on the DME.

[ADHDiabetic Mom]

For doctor visits, hospitalizations, and emergency treatment, we pay only the first $250 per year. :rolleyes:

For insulin and supplies we pay 100% of everything. :mad:

We are responsible for all costs of diabetes camp (over $2000 per year), but we have been blessed with some generous financial aid. :o

Since joining this board and meeting so many generous people willing to share their extras, I think I may have bought one bottle glucose tabs. :D

[jscat]

I am shocked at how much some of you pay. And a little angry for you as well:mad:. Why should families have to worry about how to afford to keep their child ALIVE??

[cindyrn6617]

We have been blessed. We have insurance thru the hospital I work at and Tricare as secondary. Between the two, we usually pay nothing for Rx or supplies. The most we've paid was the blood ketone strips or glucagon was $9.00. For his pump, our part was around $200 and I have never seen a bill for his supplies since animas files both.

I thank God everday for having 2 insurances and my heart goes out to all of you who have to pay so much.

[Mrs. Russman]

Ben has Texas Children's Health Insurance Program (CHiP)
We pay $5 for brand name perscriptions. (2 vials of Novalog)
$5 co-pay on office visits.
PICU stay at Diagnosis $25
Pump and testing supplies no co-pay.

I'm concerned about what will happen when he turns 19 and is no longer eligible for CHiP.
I have a type-1 friend who has no insurance. She doesn't test as often, and she stretches pump sites longer than she probably should. For a while she was really insulin resistant so she was eating really low carb so she wouldn't go through insulin so fast.

[Adinsmom]

Most months we fall into the $100-$300 category edging into the $300-$500. If you included our insurance premium we would be off of the poll chart. :(

I have had to start thinking about cost cutting measures regarding D care.

[StillMamamia]

I don't have this problem as the system in Denmark is very different. Just wanted to say that i admire you for being able to deal with all the insurance issues on top of everything else. I think that is amazing :)


Ditto here. We've pretty much covered for most things. Either it's fully covered or we just pay a minor difference. This is if we have a prescription for it of course.

[jscat]

I have had to start thinking about cost cutting measures regarding D care.

That is so sad :( and infuriating at the same time (not towards you).

[dqmomof3]

We have a $10,000 deductible on our Blue Cross plan. Once then $10K is covered - happened April 2nd of this year - then we have no cap on anything and everything is covered 100%. This insurance costs us $400 per month. For $650 per month we can get the same plan but a $5450 deductible instead, which is probably what we're going to do for next year, because unfortunately, we know the cost will be at least $10,000 for each year by the time we count all the pump site changes and the insulin and the endo visits ($2000.00 alone for those four visits). This is an expensive disease!

[albasmom]

I am shocked at how much some of you pay. And a little angry for you as well:mad:. Why should families have to worry about how to afford to keep their child ALIVE??

I second that. I just don't get why you have to worry about that. My heart also goes out to all of you who have to pay so much to keep your child alive

[staciebco]

DH is self-employed, and we are self-insured through a HMO. Last year with dx's and pump purchase, we were out of pocket almost $35K, including premiums. This year it's a little better and I'm anticipating it to be around $15K. It's ridiculous how much health insurance costs, and then having to fight to get things covered. :mad: I've written our Senators about this, and both Presidential candidates. I don't expect quick resolution. :rolleyes:

[buggle]

It's ridiculous how much we pay out-of-pocket when you consider that we spend more per capita on healthcare than anyone else in the world. We're still something like 34th in quality of care.

We lived in the UK for 3.5 years. Of course, we were never sick there where healthcare is free. It felt really odd when I went into the doctor to get my thyroid medication. You just go in. No one asks you how you'll pay. They even gave me my thyroid meds for free. Healthcare is for everyone. No one ever worries how they'll pay for it. That stress is completely removed. If you're self-employed or change jobs or even unemployed, no worries.

When we got back to the States, within a few months I had some really serious neurological problems. I resisted going to the doctor, because we have high deductible insurance. I waited it out a week and finally went in. They thought I had a brain tumor. The MRIs alone cost over $6K. I didn't have a brain tumor, but damage to my spinal cord -- probably autoimmune in nature. We maxed out our policy. A few months later, we all get sick and went to the doctor and I was shocked when the insurance didn't pay for it. My husband started his job right at open enrollment and I figured we had a year under our deductible. Wrong. It reset a few months after he started working. I had 3 tumors in my breast after that and it maxed the insurance again for all the tests and to have them removed and biopsied. Then, my son got D. We have been drowning in medical bills. It's about 30% of our take-home income.

People around the world don't understand how a rich country like ours can have a medical system where people don't have care or can go bankrupt and lose their home and all their assets trying to get healthcare. It really is a total disgrace.

[redmcgee]

No problem. :) This could take me awhile to figure out though. We just quit APlus Medical.

We're probably over $100 a month if you want me to get specific. :)


Is there a reason why you quit Aplus Medical?????
We have gotten our for 1 month now.

[redmcgee]

Before we got Aplus Medical we spent $30 for each prescription.
$120-$150 a month.

[speakup4kids]

This is my biggest problem right now!! For January-May I spent an avg of 1200 a month between insulin, supplies, etc... With the medication I need I was spending over 2000 a month on medicine alone. While we have now hit our deductible and pay 10% of everything for the rest of the year, all my other bills are two months behind. You know that you have serious problems when you have to make a choice between your home and your child's health. I wish this stupid healthcare system would improve. We have always been insured, my husband has a good job but all it takes is one disease to make it all spiral downwards!!!

[U of I Mom]

We pay 100% for CGMS supplies. Insulin and test strips we pay 30%, pump supplies we pay 10%, doctor appointments we pay 10%.

[JohnMom]

We get 2 months worth of testing supplies for free. We pay $15.00 for 2 bottles of insulin and syringes (4 boxes). We use BD 33 lancets, which is not covered because our HMO uses 28 gauges, so we buy out of pocket. We also buy out of pocket the Blood Ketone strips. Hubby has good medical insurance all doctor visits are free, along with the MM522 we just got but will not be trained on until July 2.

[Twinklet]

We pay $9 for strips, lancets and insulin. The pump and pump supplies are free. Endo visits are free. We have Tricare Prime.

We get the Navigator free now but we'll have to pay starting this fall (unless I can convince Tricare to pay for that, too!).

However, there are so many other costs associated with D that insurance doesn't cover:

Glucose tabs/low supplies
Pump Holders
D Camp
medical jewelry
Jonas Brothers tickets (OK, maybe that doesn't count....:p)

[funnygrl]

My asthma costs me more than my diabetes. I pay $15 for a three month supply of strips & pump supplies, and $10 for a month of insulin. $15 per doctor's visit, generally every 3 months.

[shekov]

WE pay 20% of ALL prescribed supplies. I honestly haven't sat down and added it up...DENIAL.

We have a cap as to how much we can spend out of pocket before insurance picks up costs 100%. Guess what it is? C'mon...Guess!

It's almost EXACTLY what our out of pocket costs are for a year!! How much time do you think they spent figuring that out....:rolleyes

[lilituc]

I know I would definitely buy more test strips if I could. As it is, I already pay for 200 per month more than my insurance covers. I never have enough blood ketone strips to be all that useful (and I ended up in the ER in December), either. Let's not even get into my insurance premiums, or what I had to do to get health insurance after our COBRA ran out. (My husband's company doesn't have benefits).

[CJ's Mom]

I guestimate I pay between $75 and $100 a month on D supplies, not including insurance which is $48 a month through my employer for me and the two kids. Prescriptions are $25 ea. for a 3 month supply including insulin and strips and blood ketone strips, insurance does not cover syringes or pen needles :confused:, CJ likes to use alcohol wipes although not necessary.
And I'm also cutting costs where I can because of D.

[musicjunkie]

One Touch Ultra Test strips.It says 60 day supply.Quantity 300.That only lasted me 1 month.(50 bucks)I just had to run to CVS and pay full price for 1 bottle til I can call Umass in the AM.(cost 27.09)
Before he started the pump he was getting 200 test strips for 25 bucks.

One Touch Ultrasoft Lancets.It says 75 day supply.I recieved 900.It cost me 75 bucks and will probably last me 900 checks(I change them everytime-minus a few latenight checks)I look at it like they call them disposable for a reason...
I'm also gonna call Fallon in the AM.Maybe they can explain to me what I can't seem to figure out over here...after seeing this post and running to look at reciepts and labels,I'm wondering why Fallon is covering us 900 lancets for 90 days but only cover 300 test strips for 60? Shouldn't I get just as many or if anything more test strips? Technocholy I COULD reuse a lancet.I can't and have had errors or needed to retest w/ test strips.
I was paying 25 bucks a bottle for Lantus + Humalog(1 Lantus + 2 humalog a month=75 bucks) but since we started the pump they switched me to 3 month supplies and now it's only Humalog and I get 7 bottles for 75 bucks.
When he was using syringes they cost me 25 bucks for 200.

I also just got a precision extra for free from Umass. 100 keytone strips cost me 100 bucks.

Glucagon 25 bucks.

ALL of his Animas supplies are free and shipped to me every 3 months(I love Animas:))

Although looking at what some of you people pay maybe I shouldn't call Fallon...instead of increase test strips,they might cut back on his Lancets