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Cost of Diabetes – Insurance, Insulin Prices and Complications

Diabetes is an expensive disease. Americans diagnosed with diabetes have healthcare costs that are 2.3 times greater than those without the disease, according to a study released this year by the American Diabetes Association (ADA).[0]

Between hospital and doctor visits, prescription medications and supplies, the cost of treating diabetes in the United States is $327 billion annually, a figure that’s risen by 26% in the last five years.[1]

Do you need help affording your insulin?

In the remainder of this blog post, we’ll talk about the financial impact if you’re at high risk for Type 1 or Type 2 diabetes, have been recently diagnosed, or have a loved one coping with the disease.

Getting the Diabetes Diagnosis

The term diabetes actually refers to several diseases caused by excess sugar in your bloodstream. Type 1 and Type 2 diabetes are chronic conditions that are diagnosed with one of these blood tests done in your doctor’s office[2]:

  • The simplest and quickest test, called the glycated hemoglobin (A1C) test, indicates average blood sugar for the last two to three months. This type of test is often used in free diabetes screenings at hospitals and pharmacies, too.
  • The fasting glucose test involves a fast for eight hours before your blood test is performed.
  • The oral glucose tolerance test involves several blood tests over about a three-hour period. During that time, you drink a liquid with glucose mixed in, and have your blood tested at regular intervals.
  • The zinc transporter 8 autoantibody (ZnT8Ab) blood test is used specifically to determine if you have Type 1 diabetes.

The Cost of Diabetes

The ADA’s recent study indicates that people diagnosed with diabetes spend an average of $16,752 per year on medical costs.[3] About half of that (57%) is related to treatment, including the cost of diabetes medication.

Insulin therapy is a common treatment for people with Type 1 and Type 2 diabetes, but insulin prices have skyrocketed in the last several years.[4] Diabetes Management’s digital edition reports that the cost of insulin has increased from $100 to $200 per month to $400 to $500 per month, depending on the brand.[5]

Diabetics with no insurance must pay those costs entirely out of pocket.

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Getting Diabetes Medication Costs Under Control

If the cost of diabetes medication has become out of reach for you or a loved one, try bringing your medical expenses down with these strategies:

  • Check with your doctor about an alternative if you currently use one of the newer manufactured insulins. Human insulin is an older type of medication that can be less expensive.
  • If you take a diabetes medication other than insulin, ask your doctor about a generic alternative.
  • Explore any prescription drug programs at your pharmacy which offer reduced prices for a low monthly fee.
  • Compare your medication costs to one of these online drug discount programs and consider making the switch:

The Real-Life Toll – Complications of Diabetes

Diabetes can take a toll well beyond high monthly medical costs. Approximately 30% of the annual $327 billion in diabetes spending is for prescription medications used to treat complications of the disease.[6] Another 30% is for hospital inpatient care.

Left untreated or not treated consistently, both types of diabetes can progress to serious, even life-threatening health conditions such as[7]:

  • Blindness
  • Kidney disease and failure
  • Nerve damage
  • Amputations of fingers, toes and legs
  • Heart disease and failure
  • Stroke

Early detection and treatment are important in preventing the progression of the disease. A University of Michigan study found that early detection and treatment of Type 2 diabetes is likely to reduce the risk of complications such as heart disease.[8]

Your own medical expenses related to diabetes will depend on many factors, including timely detection, the stage when it is diagnosed, and the quality and consistency of your treatment.

Reduce Your Risk of Diabetes to Preserve Health + Finances

Genetics, ethnicity, age and lifestyle choices can all put you at risk for developing diabetes. However, being proactive will help reduce your risk and even prevent the disease.

Here’s how to prevent diabetes, improve your overall health, and save money:

Visit your doctor for a screening

Though some screenings are free and convenient, healthcare professionals typically use the A1C test, which may not provide enough information to give you the full picture. Here’s why screening is essential: The Centers for Disease Control reports that 84 million Americans have prediabetes, a condition that can lead to Type 2 diabetes within five years if left untreated.

Many adults don’t know they have prediabetes, so they don’t take advantage of that critical window of time for preventing diabetes.

Eat for health

Blood sugar levels are impacted by the foods and drinks you consume. The ADA recommends avoiding food and beverages that are high in sugar and refined carbohydrates. Instead, make dark leafy greens, low-fat proteins, fiber-rich foods, water and unsweetened tea a more regular part of your diet.[9]

Stay active

Exercise decreases the amount of insulin needed to keep your blood sugars in check, so regular physical activity is extremely important in preventing diabetes. Regular exercise can keep your weight at the appropriate level and help you avoid obesity, which is another risk factor for the disease.

Reversing Diabetes to Save on Insulin + Medication

It is possible for people with Type 2 diabetes to return to normal blood sugar levels with changes in their diet, exercise and lifestyle.

Depending on the timeliness of your diagnosis and treatment, it may even possible to discontinue taking insulin. However, healthcare professionals are cautious when talking about  reversing type 2 diabetes.[10]

Some point out that even though the progression of the disease has stopped when normal blood sugar levels return, the previous damage to cells still exists, and the disease can return if healthy eating and exercise habits are not maintained.

With Type 1 diabetes, changes in diet and exercise can bring your blood sugar levels closer to normal levels and reduce your dependence on insulin. Though exciting new treatments are on the horizon, today Type 1 diabetics must remain on insulin.[11]

Health Insurance Can Help with Diabetes Costs

Your health insurance may help you keep the cost of diabetes manageable by providing coverage for:

  • Prevention and detection – regular wellness visits can help your physician spot the signs of prediabetes and diabetes, which can lead to earlier detection, diagnosis and treatment, and reduced risk of complications.
  • Insulin therapy and other medications – insurance can help with out-of-pocket costs for prescription medications, insulin therapy and other treatments.
  • Access to supplies – the supplies needed for self-management of diabetes are essential to successful treatment. Insurance can help with the cost of supplies such as testing monitors, test strips, and lancets.

Common Questions About Diabetes and Health Insurance

With all of the uncertainty about changes to the Affordable Care Act, it can be hard to find the right insurance for diabetics. Here are answers to common questions about diabetes and health insurance:

  • Is diabetes considered a pre-existing condition?  Yes, many insurers consider it a pre-existing condition. However, ACA-compliant plans cannot deny coverage for diabetes or other pre-existing conditions. Group plans may delay diabetes benefits for a certain time period.
  • Do insurers offer riders to cover diabetes?  Yes, some do. Be sure you review the policy carefully and ask questions to get a clear understanding of what is and is not covered.

If you’d like to explore your options, call today to speak with a health insurance producer about major medical health insurance.

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