The Benefits of Benefits
Diabetes and the medical insurance battlefield.
By Kerri Sparling
October 2010 — When I was a kid, I had the luxury of being on my parents' insurance policy. So I didn't have even the slightest clue about what it takes to navigate managing a chronic illness within the confines of medical insurance. As far as I was concerned, test strips arrived randomly and were stacked in the bathroom cabinet, syringes were delivered as often as the mail, and a six pack of insulin was always on tap in the fridge.
It wasn't until college that I realized "Oh crap, I'm going to be on my own when I graduate, and I'd better get myself a job with benefits."
Diabetes hasn't compromised my ability to fall in love, make friends, or have fun, but it has definitely put a damper on my freedom. Due to the constant maintenance drugs and the lurking possibility of a health-related emergency, medical insurance is an absolute necessity. Without insurance, my financial health would dictate my medical health. In regular Kerri-terms, this means "No backpacking across Europe for three months unless you're on insurance-supported sabbatical from your job or have medical insurance through your spouse."
This constant quest for insurance had me working two days after I graduated from college. It's also kept me at jobs I haven't liked, and has kept me timing my quit-start dates between jobs so that there isn't a moment of lapsed coverage.
I don't envy people who can eat whatever they want without bolusing and I don't harbor resentment towards those who don't worry about hiding their diabetes hardware, but I do have a lot of wistfulness for a more whim-lead life. From my vantage point – type 1 diabetic for 22 years – I can't understand the idea of just freelancing or saving money and then traveling for a few weeks or "quitting that crappy job and seeing what happens."
In these tough economic times, people are far more careful about taking job risks and are in that "save for a rainy day" mindset. I think that the country as a whole has finally caught up with how diabetics have been forced to think for our entire lives. I feel like a little type 1/type A squirrel, hording test strips and insulin and pump supplies "just in case." With a disease that requires a good amount of maintenance and work just to cling to status quo, my brain doesn't even allow itself to think whimsically.
In addition to being a whimsy-limiting factor, insurance can also be a battlefield. Over the course of 2008, I fought for months against my insurance company because they continually denied coverage for my continuous glucose monitoring system. As someone who has been diabetic for decades, is pursuing pre-pregnancy planning, and struggles to keep my A1C steady, you'd think I would be an ideal candidate for approval. But it took eight months of appealing (multiple times, including letters from my doctor, the CGM company, me, my mom, the Pope, Bono, and three of the original members of Menudo) in order for the denial to be overturned. The thrill of victory was a bit soured by the frustration of having to do it in the first place.
There are things to be thankful for, though. I have a job I enjoy very much, plenty of time off for fun, and I have the diabetes-equivalent of a "keg" of insulin in my fridge. I work hard to maintain my health and I make sure I appreciate the benefit of benefits, perhaps in ways that my other friends don't. Insurance isn't perfect (far from it), but as the economy tumbles, I'm grateful to have it.
Visit Kerri's website.
dLife's Viewpoints columnists are not all medical experts, but everyday people living with diabetes and sharing their personal experiences, most often at a set point in time. While their method of diabetes management may work for them, everyone is different. Please consult with your diabetes care team before acting on anything you read here to find out what will work best for you.
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As I mentioned in an earlier post, one of the benefits that made it cost-effective for me to go with the real healthcare (HSA) plan rather than the phony (HRA) plan is that my company is now covering "preventative" medicines at $0 copay. The formulary for these, as stated by CVS/Caremark (my pharmacy benefits provider), covers all test strips, lancets, and control solutions. I dutifully get my doctor to write up prescriptions for all of my testing needs, submit...