Insurance Unequality

I was not going to post today but I just got off the phone with BlueCross BlueShield insurance companies “customer service.” I received an EOB (explanation of benefits) regarding my insulin pump supplies from MiniMed. Apparently, BCBS has decided MiniMed is not in their Network according to the plan I had signed up with. This was news to me and I wanted to know what my options were. The customer service agent asked: “Why can’t you just pick a different medical supply company?” I pointed out to the agent to stop and consider this question as one of the least informed questions I have ever heard. The agent replied: “Well I don’t know much about Diabetes.” This is what is wrong with insurance companies. Diabetic patients do not have ‘generic’ choices for care like other diseases may have. There is no ordering insulin pump supplies from any other supplier because there is no other supplier. As a result, my $1,000 deductible has now become an out of network deductible of $5,000. When asked what would help me, the agent stated I would have to have a different plan to qualify MiniMed as in their network (another joke). I asked how I could switch plans, to which the response was: “You may not switch plans until next January.” At this point I am ready to wrap my hands around the phone….

Something similar happened a couple of years ago when I was with Health Partners and they decided the insulin that I was using, Novolog, was not in their formulary which meant I was to pay over $200 per bottle of Insulin…a 90 day supply for me is 4 bottles…do the math. The insurance company forced me to switch to Humalog, an insulin that has not, typically, worked well for me. And like the customer service agent with BCBS, told me that Humalog was the ‘generic’ form of insulin that was cheaper, I called BS and told her there was no difference in cost or content…insulin does not have a generic.

What is disturbing to me relates to the general ignorance insurance companies have regarding the extremely limited options diabetics have. The corporations make random decisions about care of diabetes that look good on the P/L sheet but leaves people with diabetes with huge bills to pay. The pump supplies alone are $1200 for a 90 day supply, four times a year makes the cost $4800 a year….and the out of network deductible is $5000, sound like the insurance company knows this.

My question is this, how do we help insurance companies understand the burdens put on type 1 diabetics looking to remain healthy regulate their blood sugars? Are we forced to return to needles to save money? Our health care system is broken, I am not asking for something I am not willing to pay my fair share, but people on insulin therapy have few if any alternate choices when it comes to managing diabetes. It would be nice if insurance companies valued the health of everyone, not just the ones who can afford it.


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