Monday, February 11, 2013

Health Insurance And Stress

This is my first year with a high deductible health plan and I'm stressed. My husband's employer made the switch in late December. I have always had traditional health insurance. Lots of co-pays and a $1,000 DME deductible, but it was spread throughout the year. Now I need to pay upfront for everything until we meet our deductible. I went to pick up my two boxes of insulin pens. Instead of my normal $50.00 co-pay the bill was $713.99. I was stunned. I told the pharmacy I couldn't afford my insulin and they were understanding. I will get my prescription changed to vials. I'm grateful I got a pump last year, except now I have to figure out how to afford supplies. I don't know how I am going to manage and I am afraid.

My husband's boss did not help us start a health savings account, or give my husband a raise to cover the out of pocket slam dunk. It felt like being dropped into a dark hole. I've been crying a lot. Doesn't chronic illness cause enough suffering without an added financial kick in the face?

My parents helped my husband and me start a health savings account. I am beyond grateful that they were able to help. I know that I will adapt to the changes in time. Right now it feels overwhelming. These past few weeks have been hard on me. Are my doctors still in-network? What are my in-network sources for pump and Dexcom supplies? How will I afford my medicine? And test strips? I am feeling cornered, frightened, and stressed.

Stress is hard for me to deal with. I don't process it well because of chemo brain. Between 2005 and 2007 I had 23 back to back cycles of moderately high dose chemotherapy. One week I would get an infusion and then I had two weeks of rest. Every three weeks the cycle repeated. I did this for 18 months. The chemotherapy was a derivative of a World War I chemical weapon called mustard gas. One of the few drugs that can cross the blood/brain barrier, the toxic medication bathed my brain in poison.

I had problems with memory almost immediately. I had trouble finding words. What is the name of the box on the counter you put food in and it gets hot? I called the oven the dishwasher. I called the dishwasher the washing machine. It felt as if my words were in drawers and I couldn't access the right ones. At first it was funny, but my cognitive impairment got worse.

I had trouble understanding what I read. I could recognize the symbols, but they lost their meaning. I had a 4.0 GPA in college and I couldn't read my own grocery list. A few weeks later I couldn't figure out what a shopping cart was for. I held the handle for a long time. Tears streamed down my face. I knew I should know, but I couldn't figure it out. When I finished shopping I couldn't remember how to write a check.

As bad as this was, my dementia symptoms increased. I got lost four blocks from my house and couldn't remember how to get home. I knew I was supposed to know where I was, but suddenly nothing looked familiar. I was scared senseless. Fortunately I wasn't alone. My service dog noticed I was distressed. I followed Honey as she made left and right turns. She took me home. I never trained her to do this. Honey just knew I needed her and helped because she is my best friend. My hero has fur and a tail.

I was in my mid 30's and suffering from increasing dementia because of the chemotherapy. My doctor and I had a discussion and she brought up The Hippocratic Oath: "First, do no harm." The treatment had become harmful. We decided to stop the experiment. Twenty-three cycles of chemotherapy later, MG refused to go into remission. There was no point in trying a 24th. I still take chemotherapy to manage my severe MG. It's just less toxic and I take pills at home.

After I stopped the intensive chemotherapy, the dementia symptoms went away, but they left a shadow. The shadow makes it harder for me to cope with stress. When I am stressed the dementia symptoms return. They are milder, but still hard to manage. Fog rolls into my mind. It clouds my ability to think and make decisions while intensifying my emotions. Having my health insurance change dramatically has increased my stress and lowered my quality of life. We make too much money to qualify for federal or state programs, but not enough money to afford health care with a high deductible. Ever since I saw a bill for $713.99 for insulin, I've been frightened that I won't be able to afford my health care. I'm having a tough time keeping my fear in check. I've fallen down. I need help getting back up.

If anyone has any suggestions or tips on managing diabetes with a high deductible health plan, please let me know. I've been stressed out. Can you help me find my way out of the fog?


  1. This comment has been removed by a blog administrator.

  2. We've had HDHPs over the years and also switched to that plan again this year. The downside is a costly 1st half of the year. The upside is you'll likely have no cost starting around May. It really makes you aware of what you are spending. It also makes you aware of programs that help with co-pays.

    Apidra has a great program to help with insulin...that will save you $100. If you aren't already using it, ask your doctor for a new prescription.

    Test strips can get super expensive. We have been on One Touch for 10 years. I went to pick them up 2 weeks ago and the bill was $325. I asked the pharmacist to keep them and did some research. Your health plan likely has a calculator where you can compare drugs as well as compare your delivery method...90 day supplies (mail order) vs 30 day (in store). We learned that the Bayer Contour is SIGNIFICANTLY cheaper than One Touch AND they also have a savings card. My new total was $169.

    You will need to have the money upfront for prescriptions, but not for your doctors. Let each doctor you see know that you are on a HDHP. They can put you on payment plans for their services.

    Once you meet your deductible, start stocking up. In other words, once your prescription costs go to $0, always refill a prescription on the 1st day that you can. I believe it's like 20 days between refills on a 30 day script. That will give you some back stock for next year.

  3. Thank you for the suggestions. I've been beside myself. I just called my insurance company. I can get test strips online from any mail order company I choose. Now I can search for what will work for me.

    Little by little I am climbing back up. Thank you for boosting me up. It means a lot to me.



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