As an insulin-dependent diabetic, I’ve been a real fan of health insurance. I live at a time when I can live an almost normal life, even though my body can’t really process my food into energy properly.

Not many years ago, someone who was insulin dependent could expect a few good years of life, then artery disease, vision problems, leg problems, followed by amputations and blindness were almost guaranteed. Not so any more. Sure there are a few folks with diabetes who are older, who don’t check sugars, don’t go to doctors, and don’t manage their diabetes. They continue to pay heavy prices. I am not one of those.

I go to all my 3 month appointments. I check my sugar regularly. I take my meds, and keep my weight down and exercise. When insurance is there to help out, and helps with a good bit of my prescriptions, life is great. But the past several years, the past 3 especially, the cost of insurance, deductibles, and now meds is really hurting. Health insurers want to do less and less, and charge more and more.

Last year I signed up with Anthem’s Express Scripts, and the prices I was paying at Kroger for prescriptions was nearly cut in half! I was SO excited. As we all know, each time the insurance goes up and meds get more expensive, it is like taking a big pay cut. Not fun. However about 6 moths with Express Scripts, I noticed my drug prices were nearly back up to what Kroger had be charging for retail prices.

A couple years ago, I had a $1500 deductible, then Anthem paid 100% of my Rx needs. That was great… AFTER I paid the $1500 which hurt. Then the next year, I still had the $1500 deductible, but Anthem only paid the rest of each script after $30. Since I get about 5 scrips a month, that was $100 per month after $1500. Last year we still had the $1500 deductible, but Anthem would not pay the until we met a $2500 max out of pocket. It was getting very hard to deal with.

I’ve always been great at paying off my credit cards, but once we starting having to carry so much out of pocket each year for health care, and since my budget was nill, credit cards became my deductible resource. Easy to use, so hard to pay for…

Aside from all the fireworks with the cost of insurance, the price of deductibles, and the cost of meds, last year I got a call from the company who sells me supplies for my insulin pump, Medtronic. They said my pump was out of warranty, and asked if I’d like a new one. I try to minimize bills to insurance since I am so dependent on them. I said “my pump is working fine, why should I upgrade?” They said ‘insurance companies like the pump covered in case something happens to it’. So I said “if I can replace it without much cost, I’ll do it”. They said they checked and Anthem approved the deal, I’d pay $45 in deductibles, Anthem would get the rest since I’d met my deductible, then they’d send me a new pump AND give me a credit of nearly $500 for my old one!

• Insulin pumps cost about $3000 new!

I got the new pump and paid the $45, but found out my ‘credit’ was used to pay for the new pump, and I was charged another $300-400 for the pump in a billing mess-up I am still dealing with. What Medtronic expected and what Anthem agreed to didn’t work out. Hoping they fix that error soon!

Currently with Express Scripts, I get 90-day supplies of meds and 6-month supplies for my pump from Medtroic. Pump supplies for 6 months of vials and catheters is about $500. 3 months of insulin is about $500. Test strips for 3 months is $460; I get 3 prescriptions for allergies, thyroid, and cholesterol. Once is $350 for 3 months, one is $170, and one is about $240. So in 3 months, I average about $2000 to start the year off.

Yes I do have an HSA account, and though it has hurt, I take $100 out of each paycheck to deal with some of this as tax-free monies. But with 26 pays in a year, times $100 that means I basically have enough to cover the initial deductible, but not the rest of the out-of-pocket max.

I know that there are many others who have cancer, or are on oxygen, needing home care, or far worse diseases. So my pain may seem light to what they deal with. To these I can only pray for you to have success. But for me, this is a very tough challenge, and one that seems should not be so hard to bear.

I also found out that Anthem has not been paying any of my doctor or pharmacy expenses as a secondary provider. I have Anthem Lumenos as my primary, but Rachel has Anthem Lumenos too, and that is my secondary insurance. However, since Anthem deals with both of them, they apparently decided NOT to process any of my primary expenses as a secondary provider since they already paid – even though they are getting money from Rachel and her school district to deal with my health needs as if I was not already under their umbrella. SO SHADY!

I need to have a talk with the Ohio Health Insurance fraud department again. It sure sounds like Anthem is cheating me… and likely others.

Okay, grumble complete. For now….