I have spent months preparing for “this day.” I could not remember the exact date; I believed it was the end of May or June but could not find confirming paperwork. However, I have stockpiled insulin, researched, and attempted to emotionally prepare for one of the scariest days an insulin-dependent diabetic faces. Being currently unemployed, there really was no way to financially prepare for it but I suppose stockpiling insulin was one form of financial preparation.
What is this day? It is the day my ability to purchase group medical insurance under COBRA ran out.
Initially when I switched from the group plan as an employee to the right to continue purchasing group medical insurance under COBRA, I was paying the group price. A little over a year ago the employer switched to a 3rd party COBRA administrator out of West Warwick, Rhode Island. At that point, the cost increased by an additional 2% (on top of the typical annual premium increase) the federal government allows employers to pass on the cost of the administrator to the former employee. The total monthly premiums were $445 but the plan was one of the most generous BC/BS of Massachusetts has.
It was a PPO meaning, among other things, there was no deductible, medical care was available outside Massachusetts if necessary and co-payments for physicians, lab tests, physical therapy, etc. were $15. Prescriptions for 30-day refills at a retail pharmacy were $10, $25 and $45 (generics, tier 1 brand name and tier 2 brand name). You could save more money using Express Scripts but I had quickly had bad experience with them shipping to an address I had not given them and was doubled-billed for their mistake. I gave up trying to get the account straightened out and switched back to my local retail pharmacy. Their loss was several thousand dollars of insulin, test strips and syringes left on a porch!
So, I figured out other creative ways to get the most out of my prescription dollar and tried to beat the insulin manufacturers at their own wasteful packaging game. Because I use relatively small amounts of several insulin products per day, there can be a lot of waste every month. Parents of juvenile diabetics suggested, especially for the 3rd tier insulin, I buy insulin cartridges and continue using my ½ unit syringes to pull the insulin out. The cartridges come in five-packs as opposed to single vials. Therefore, based on my volume I could get five months of insulin for a single co-payment – a huge cost savings! I could not save anything on test strips unless I switched back to Express Scripts since 1) we’re forced to use two of the most expensive manufacturers (due to kickback arrangements) and 2) I use 15 test strips a day. Relative to syringes, for some reason they think I only need 8 syringes per day even though I take 12-15 small shots per day (much less expensively replicating a pump) but they would only pay for 8. Therefore, I have continued to reuses syringes to the dismay of most medical professionals. At almost the 33 year mark, I have yet to infect myself so it can not be all that risky. Mostly, I just tend to bruise when the syringes get dull.
To be continued ....