transatlantic_chap

I was hoping to hear from people who have had T1 diabetes care/support in both countries.

How would you compare the two? Is the US setup insanely expensive? How do you feel about the standard of care you've received?

Rete

I'm not a Brit, nor do I have Type 1, but rather Type 2.

For myself this means twice annual visits for blood work to check A1C number and kidney function. Some of the drugs for Type 2, damage the kidneys.

It is an expensive disease. Meds can be very costly. I take two types of drugs for my diabetes, which btw, has been under control for nearly 2 years with A1C numbers well under 6.0 (last one was 5.7) and one drug which has a side effect of protecting the kidney. My average monthly cost for meds for the disease is $90. I do not test my sugar so I have not included info or cost on test strips and needles.

Insurance pays for the blood work and the doctor's visit less a $30 co-pay on my part.

Then there is the yearly mandatory visits to the foot doctor and the eye doctor.

Your costs will vary depending on the type of insulin you use, and more importantly, your healthcare insurance.

I have found even when I moved to another state within the country, that the level care was consistent and diligent.

transatlantic_chap

Is diabetes seen by insurers as a dreaded 'pre-existing condition'? Can you be refused coverage if you have it?

durham_lad

While the ACA is still in force you cannot be denied insurance for a pre-existing condition. This was not the case before the ACA was passed a few years ago and could always change since the ACA has been under attack since the new administration took over with multiple attempts to repeal and/or replace it.

chawkins99

I've been type 2 for 20+ years. Been State-side for 15.

I don't see much difference in quality of care between the 2. Biggest difference is cost. I have never been refused coverage due to pre-existing but have always been on employer (group) insurance. ACA prevents them refusing coverage but doesn't stop them 'loading' the price.

I use the pre-filled pen type insulin which costs me $50/month. The retail cost without insurance would be around $2,600/month. My wife is also diabetic and uses the more generic insulin in vials. Retail cost on hers is around $800/month but the insurance cost is still $50/month so I have no incentive to use the cheaper brand. The insurance could give us the cheaper insulin for free and save everyone money but that's not how they work, apparently.

I also take a once-weekly injection (Trulicity) which helps with my own insulin production and stabilizes my blood sugar. That one costs me $25/month with a manufacturer's discount. Without the discount, it would be $75 but without insurance would be $675.

Doctor's visits cost me $25 per visit. I also get my eyes checked twice yearly and costs the same $25. That usually includes full retinal imaging.

As I'm sure you know, but for other readers, once diagnosed as diabetic in the UK, all prescriptions are free (no per-item charges).

I have concerns about how we will afford our meds after retirement. I don't fully understand the Medicare system here. I have a few years to work that out.

durham_lad

It may all have changed by the time you go onto Medicare but I have a friend in Texas who is a diabetic and on Medicare. His wife has various other medical conditions including COPD. Last time we spoke (end of 2016) the cost of Medicare plus supplemental insurances to cover the out of pocket expenses and prescription drugs was ~$7k/year for the two of them. (With Medicare part B you have to pay 20% of costs and there is no maximum out of pocket costs).

The prescription drug plan (Medicare part D) has a "donut" hole that they go through every year. The drugs are subsidized up to a certain degree then they have to pay full cost until they have paid enough out of pocket to go back into subsidies (at least I think that's how it works). In all he said he pays over $15k / year for premiums, doctor visits and prescription drugs.

https://en.wikipedia.org/wiki/Medica...D_coverage_gap

Rete

Yes, it is a pre-existing condition. What else would it be? You have been diagnosed previously, so it is a disease that you have.

With today's healthcare, no you can't be refused coverage but expect higher premiums.

Rete

I'm on medicare and there is no difference in the cost for me with medicare and my supplement as before when I just had regular healthcare provided by my employer. It is still only co-pays (which seem to increase annually). I have a private drug plan which is part of my supplement.

I don't require injections as you and your wife do as the oral meds do the trick nicely.

petitefrancaise

I've been following a company over the last year or so and they've just published research in the peer-reviewed journal Diabetes Therapy which is very, very promising.
They monitor key biomarkers and advise on diet.
https://blog.virtahealth.com/virta-h...ease-patients/

kins

I thought higher premiums for pre-existing conditions were also now illegal under the ACA?

Rete

It raise the premium for private healthcare.

brettanybates

Thanks for sharing this .It helps many people to gain knowledge about the diabetes care.

Duncan Roberts

It can be expensive. I use about three vials of humalog a month which costs roughly $300 a vial without insurance. Insurance will affect that, you may have a copay or a deductible. I have a deductible so I have to pay teh first $2700 of medical and prescription costs so that is wiped out in one 90 day prescription. I think it's probably easier to get pumps and CGMs here, but again, there is a cost. Mine are covered 100% but if they weren't, they are not cheap. Some insurance companies force you through a distributor for these things and they jack up the price hugely, like 2x or 3x the actual price.

jcampo

Diabetes care costs are skyrocketing in the US if you use insurance. It's cheaper to pay cash for meds and testing when possible.