Insurance woes

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It’s my favorite time of year (please note,  I’m typing this with my sarcasm font). January brings a brand new insurance company and deductibles and so far this year, in the first 27 days we’ve spent the following:

Contacts and glasses for Nicholas: $283.00
Prescriptions for Michael:  $989.68

We currently pay $336.44 a month in insurance premiums. Our deductibles are $3,000 individual/$6,000 family. Once we meet the deductibles then we pay 20% of the next $2,000 towards the individual out of pocket or $4,000 for the family out of pocket. We had the large deductibles last year with Humana but the 20% after the deductible is new with our Anthem plan. This means a minimum of $2,600 more that we’ll have to pay this year then we did last year and that’s assuming that only Michael maxes out his insurance this year and Nick and I are lucky enough to not have to use our insurance plan too much.

I hate all things politics. I WILL NOT get into a political debate here but I can tell you that the United State’s current health insurance program is severely broken. This is not an attack on the Democratic or Republican party separately because my insurance has continuously sucked over the last 9 years regardless of who has been in charge. I say 9 years because that’s how long it’s been since Michael was diagnosed with diabetes and brought the issue of health care costs to the forefront for us specifically.

Michael is a “good” diabetic in that we’ve had very minimal diabetes-related issues such as hospitalizations. We had one ER trip that was a cautionary trip when he got overheated during his junior firefighting class and the training officers couldn’t get ahold of me. We had one intensive unit stay this past August when his insulin pump failed and he developed DKA. According to his doctors they have patients that are routinely hospitalized numerous times a year so I feel very fortunate and grateful that Michael manages his diabetes fairly well. Despite being a “good diabetic”, diabetes is a crazy expensive disease. His insulin is over $700 a month, test strips that generally last about 3 months was around $300.00 last time we paid for them, and insulin pod supplies for his insulin pump were about $800 for three months worth of supplies. I don’t even have a cost to reference for his CGM because we’d already met our deductible last year when we ordered those so there was no out of pocket costs for us then but I’m guessing that will probably be comparable to the insulin pod supplies. I think you probably get the drift…

Keep in mind, the numbers above is for our family, who has an employee sponsored health plan with a well-known national insurance company. What do the people do that don’t have insurance or can’t afford the medicine? I’ll tell you what they do, they either don’t take their medicine properly (taking less each time then prescribed or skipping doses) so that it lasts longer or they don’t take it at all and then they get sick or die. This is a problem Washington!!

Michael is currently in school studying to be a registered nurse. I hope and pray that he will have a job that has decent health insurance plans to pick from in the future but it really burns me to think of the financial burden this will have on him on top of having to deal the the physical and mental challenges the disease poses on a daily basis. Currently I take advantage of our HSA plan to sock money away each pay period to go towards these exorbitant costs and I use part of my tax refund money towards these costs as well. Once our deductibles are met for the year we make sure to get refills done on a regular schedule even if he’s not completely out of the product so that we have a little bit of buffer hopefully at the beginning of each year before we have to meet the deductibles again.

Let me just say, that despite this bummer of a post, that I do realize I have a lot to be grateful for. It’s definitely tight at times with the budget but I can pay for Michael’s diabetes supplies. I am grateful that I can keep Michael on my insurance if we need to until he turns 26. I do pray constantly though that something happens in Washington, sooner rather than later. Something has to change so that it’s not so tough for people to pay for their medicine or have to worry about battling their insurance companies over what they will and won’t cover for chronic illnesses.



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