Yes, this is fine. Everything is fine.
Grateful to live in a time post 1922. Thankful to have not developed this disease util my 30s. Thankful to have just enough money to afford insulin. Deeply unhappy with the current state of insurance in the US.
Im currently in the health exchange here in Oregon with the Pacific Source Standard Bronze Plan. I’ve had good experiences with them in the past, saw that Novolog was covered. Should be good to go. I start the year off by breaking my left leg in a climbing accident. I return home to find my house had been wrecked by ice damage. A couple weeks later I break my other foot. "It’s ok. I have health insurance and health savings" I tell myself. At least I have a stockpile of insulin in the fridge. Some time goes by and I start to notice my insulin isn’t as effective. Switched to a much older pen living in my fridge and find that my normal dose is effective as usual. Great. My stock pile has gone bad.
It’s ok. I have $50 co-pays on insulin like last year! Im good to go. I’ll just call up my Dr and get my script refilled. No avail. Dr has retired and failed to fill my script like he said he would. I precede to beg my primary care Dr for a script. Some time passes and the script is finally filled. It’s for Humalog, which Pacific Source does not cover. More time on the phone. More begging and the finally the right script is called into my pharmacy. I can finally have something other than plain salad I tell myself.
In a separate incident, I call in to get my test strips script filled. Which I can do at the low low cost of $430/200 strips. Wait what? I have a nice chat with a Pacific Source agent in which she informs me that test strips are a durable medical device and are not covered until I reach my deductible of $7,500. This is fine. Everything is fine. Im lucky enough to live near a walmart. $35.76/200 strips will suffice.
I get a call from my pharmacist the next day. She’s distraught. I swallow hard. No insulin is a tier I drug with my plan. I therefor have to pay full price. This is fine. Im fine with this. I’m not fine now. At $570 for ~ 3 month supply for just my fast acting insulin + my $330/mo premium, Im no longer able to reassure myself. For the first time in my life Im genuinely worried for my healthcare security. "This is fine” I tell myself.
The next day I get a call from a lovely agent at Pacific Source. She felt awful about telling me I wouldn’t be covered. I assure her she’s just the barer of bad news. She directs me to a program administered by Norvo Nordisk that offers up to $100 off for each prescription. I proceed with cautious optimism & inform my pharmacist of this application. She says she’ll try it once the Dr corrects the initial script.
At the moment, Im looking at the last 20 units of my Humalog pen. Given my body type and carb intake I can make this last another 4 days. Tomorrow I find out if the new script goes through. If my insurance will cover some of it. So fingers crossed. Worst case scenario, I just buy insulin from walmart and deal with long lead times prior to eating. That will work out fine Im sure.
I don’t write this for upvotes or to beg for resources. Just to share my story as a show of solidarity. Did I make mistakes? Oh yes I did. I didnt read the fine print and confirm that this plan would cover my essentials. On the whole this is not that bad. I could pay more for less. This could be a hopeless situation. I could be dealing with much worse health issues. This is just the slow, but painful insidious nature of this disease. Death by a thousand BG tests.
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