Wednesday, May 23, 2012

Dear Insurance Company: A DSMA Entry

“This post is my May entry in the DSMA Blog Carnival.  If you’d like to participate too, you can get all of the information at

(Ok, ok. I know I'm super bad at being a regular participant in the DSMA blog carnival. I love doing it, but I just get easily distracted by other things and forget to do it! It's a weakness, I know.)

There are oh-so-many-things I wish my insurance company paid for (a gym member ship? Holla?!). But, the single thing I wish they paid for more than anything else is insulin!  

OK, they pay for insulin, they're not that lame. But they do it in a crappy way. Up until this year, I just had a co-pay for insulin. It was a certain amount for a 1-month supply or a 3-month supply, no matter how much insulin I was prescribed.  This year, they've switched things around a bit.  Instead of a nice round co-pay for my prescriptions, I have to pay co-insurance (a percentage of the total cost) and my insurance company picks up the balance.  They still pay a whole heck of a lot more than I do, so I can't complain too much. But what I don't think is fair about this particular arrangement is that I get penalized for taking more insulin than someone else.  For example, if I need 3 bottles of Apidra a month, and Jane Diabetic down the street only uses 2 bottles a month, while we both pay the same percentage, Jane still gets to pay less than me because she has a lower total cost than me.  LAME!  I don't think that's particularly fair. Bodies are different, and it's not my fault that I need more insulin than Jane, right?  (I'm super jealous of Jane right now, btw) (Jane Diabetic is a fictional character and does not represent a real person that lives down the street from me, fyi)

Other than this tiny snafu, I really have great insurance. I have a super low deductible with a very affordable monthly premium.  They cover pumps & CGMs at a decent rate, and all of my test strips are free, so I really have it pretty good. The insulin coverage is annoying, though.  And it felt like a big, mean trick when they switched that part of my plan on me. 

So, to put all that into the prompt, I would say:

"I wish my insurance company paid for insulin using a co-pay system because using a co-insurance system is unfair to those of us who need more insulin than others."

1 comment:

  1. Hence, we need universal health care coverage. Sigh. Love you!