Diabetes control is costly. According to the American Diabetes Association (ADA), the average cost of health care for a person with diabetes is $ 16,752 a year, more than double the cost of health care for a person without diabetes. . one
Many people with diabetes need help to pay for their health care. Help can be found through private or government health insurance, local programs, patient support groups, and medical assistance programs. You can also find ways to save money on diabetes medications and supplies.
What health insurance plans cover people with diabetes?
Health insurance helps pay for health care, including the cost of diabetes care. The health insurance options are:
- Private health insurance, including group and individual health insurance
- Health insurance the government, such as Medicare External link, Medicaid External link, the program of health insurance for children (CHIP) External link, TRICARE External link (in English) and health care programs for veterans External link (English)
Under current law, health insurance companies cannot refuse to cover someone or charge more just because they have a “ pre-existing condition External link ”, that is, a health problem they had before the date. when the new health coverage begins.
Changes in insurance rules occur frequently and could affect your health insurance options.
Compare coverage for diabetes care
When choosing a health insurance plan, ask about all the services and supplies you will need to manage your diabetes. Does the plan cover the drugs, supplies, and devices you are using? If not, what are the alternatives? What does the plan cover? How much will you have to pay out of pocket? Must consider:
- every prescription drug you need
- diabetes supplies and devices, such as an insulin pump
- laboratory tests and screenings for diabetes
- doctor’s office visits, nutritional counseling, and specialists such as ophthalmologists
- copays and deductibles
- Healthcare providers: Are your providers participating in the plan or will you have to change providers or pay more to see your current providers because they are out of network?
Request a Summary of Benefits and Coverage, explaining the plan in plain language, including free preventive services. This summary may include an example of coverage for managing diabetes.
Private health insurance
Insurance companies sell private health insurance plans. Two types of private health insurance are:
- Group health insurance. People buy this type of health insurance through their employer, union, or through the employer or union of a family member. Professional or alumni groups may also offer group health insurance, which can be helpful for self-employed people.
- Individual health insurance. People buy this coverage for themselves and their families.
- HealthCare.gov is a way to find, compare, and shop for individual insurance plans in most states, or to connect to your state’s marketplace. HealthCare.gov also:
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- tells you if you qualify for an External link tax credit for monthly premiums and External link cost-sharing reductions that lower your out-of-pocket costs. Only people who buy plans through HealthCare.gov or a state exchange can get tax credits for premiums or cost-sharing reductions.
- lists the annual open enrollment period when you can choose or change your plan
- lists life events that allow you to buy insurance at any time of the year
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