Thursday, January 22, 2015

FYI: Insurance Co's - Life With Diabetes & Dealing With/Trying To Prevent "Real People Sick" = A Lot Of Insulin, Test Strips, Infusion Sets, ETC.

I’m thankful that I have technology and the extra insulin to fight off whatever’s going on inside me right now. But the cost of the all the extras is stressing me out and puts me on the defensive with my insurance company - And I don't feel like playing defense all the time - especially when I'm trying to prevent "real people" sick from occurring.
Why do I, and by “I” of course I mean “WE,” need to continually play defense, even when we feel like skipping the game entirely and sitting on the sidelines until we're ready to grab the ball. 
And yeah, I can't believe I'm using a sports euphemism - I'm so much more of an "Arts & Entertainment" Chick. 
Because I’m fighting off some sort of something in the cold/infection variety since Sunday, I’ve been dealing with elevated blood sugars, a scratchy throat and slightly higher than normal body temp between 98.9 & 99.2. 
I've been popping extra Vitamin C, craving early bedtimes, chicken soup and spicy food.   

And because of diabetes technology, I’ve increased my temp basal rate to 129% and that seems to keep my blood sugars in the normal range and I can go about my day without skipping to many beats. 
It also means I’ve been going through insulin like water (between 54 and 56 units per day on average since Sunday) and the same goes for infusion sets. I’m literally changing out my site every 24 hours - And not because I want to, but because it’s been syphoning so much insulin subcutaneous , it literally craps out somewhere between the 24 & 32 hour mark. 

The good news: Like I said, nothing has to be put on the back burner during the day and fingers crossed that soon I can get back to a normal amount of insulin. 
The not so great news: How does one explain to their insurance company that they are going through insulin and infusion sets because their body is actually preventing "real people sick," from occurring, thus requiring  a shitload of insulin, test strips and  pump silhouettes in order to do so? 

Your diabetes may vary, (YDMV) doesn’t fall into the insurance RX math of diabetes. 
Not only do insurance companies not understand the “diabetes math” of it all, but that don’t understand that that “your diabetes may vary,” depending on the day, the week and the year. 
You might be staving off an infection in January that require copious amounts of everything - no matter what the insurance company thinks you require. 
Which means by the time you're better, you’ve already gone through 1 box of Silhouette infusion sets and have started into your second box, both of which were part of the four boxes included in your 3 month supply (FTR: I have pay extra for that fourth box,) that was delivered on December 29th. 

No matter if you’re using a insulin pump or multiple daily injections, when your body is fighting off an infection and trying its best to stay healthy, you’re going to require more insulin and supplies - And don’t even get me started on dead spots and scar tissue.  Insurance doesn’t understand or care. 
I’m lucky, my Endo gives me insulin samples  - And I still have a 3 unopened bottles before my mid February appointment - but by the looks of things - I’m going to  be cutting it close. 
As of today, I've gone through one whole bottle of insulin since January 10th.  
This afternoon I will start a new one - What if I go through that one in 13 days? 
What about PWDs who don’t have insurance? 
What about Children in developing countries who don’t have access to insulin? 
Sidebar: Spare A Rose is just around the corner, you can literally  “spare a rose, save a child,” and provide 1 month of insulin for a child in a developing country for just 5$
And you know what? It's the best 5 bucks you'll ever spend! CHECK IT OUT!

People with working pancreases require more insulin when they’re fighting off any sort infection, so do we. 
People with working pancreases require more insulin when they eat certain foods. 
So  do we.
We have to pay for our insulin, infusion sets, test strips, extra and otherwise - And we have to pay extra when our bodies require extra - And that SUCKS. 

I wish insurance companies would allow for a cushion, a backup of supplies for all the variables of life and life with diabetes. 
Real people sick/preventing RPS and what is required for both. Insulin requirements varying from day to day, sick or not. Deadspots, tile floors and their magnetic pull towards the last bottle of insulin. Error messages on meters and CGM transmitters that get funky before their time. 

Anyway, that's how I'm feeling and I just needed to share, because I know I'm not the only one who's dealing with all of the above - And we are in this together.  


Unknown said...

Hey Kelly, hope you feel better soon!!! And for the record I laughed forever when I read that you are "pooping extra vitamin c" made my day :D

k2 said...

Maria M -
Oh crap!

Tammy said...

Will your Prescribing Dr allow you to add a little "fluff" to your totals in order to build up your supply a little for these kinds of things? Maybe you already do this? Maybe this isn't ok per insurance companies but IMO what they don't know won't hurt them sometimes. Within reason of course. ;-)

Scott E said...

I've long believed that there should be a cushion built-in to either the prescriptions, the insurance coverage, or the packages themselves. Just this past week, I had an infusion set go bad on me on Day 2, and a CGM sensor that I deemed DOA after 24 hours. (Sure, I could call and complain and try to get a free replacement, but what a pain in the ass!). So what am I going to do? Try to stretch my next site to 4 days and my next sensor to 11. What other choice is there?