Paying for healthcare?
Hi, I’m from the UK and blessed with free healthcare. Worrying about my diabetes and on top of that money FOR my diabetes is foreign to me.
I was wondering if diabetics from around the world could explain to me how the healthcare in their country works? Do you constantly worry about not having money to pay for you’re prescription?
Hi there; I’m from New Zealand, and our healthcare is partially subsidised, based on income. If your income falls below a certain point, you can apply for a Community Services card, which greatly reduces GP visits and prescriptions. Without this a GP visit will cost around $40.00, and prescriptions $15.00 per item although, repeats are generally free. I pay to see my Diabetic specialist as I see him once annually as a private patient,and have done so for decades.This is costly, but I also go to the hospital for regular checkups, eyes, feet etc, and this is free. I get 4 free visits for foot care annually.My insulin pump was no cost, through the hospital. So generally, costs are manageable for diabetics here. I use Hypo-fit for treating “lows”, and this can be expensive, but the sachets are easy to manage, and very effective, plus not chewing sugary stuff has meant a huge improvement in tooth decay. Almost nil treatment required in several years, which is pretty good because dentists are hugely expensive here.It’s all a learning curve…
So, I’m from the US…and I’m not sure I can even explain our crazy system in a single post.
I’m lucky enough to be employed by a large institution, so I’m able to be a part of that institution’s group policy, which offers reasonable coverage. But even with this policy, I do still pay for things.
Part of the great thing with my plan is that there is a limit to how much I have to pay for insulin – $20/month. Insulin can get shockingly more expensive than this. And, since I use 2 types of insulin (short and long-acting), I am really paying $40/month. Everything else is also partially covered. I end up paying around $8/month for my test strips. There is a $25 fee to see a general doctor, and a $50 fee to pay my specialist. My insurance covers 80% of my CGM supplies, and I pay 20%. And if that is not complicated enough, all other fees are subject to a really complicated system for determining how much your insurance pays, and how much you’ll be billed for. One of the big downfalls is that it is often nearly impossible to be certain of the amount you’ll be responsible for in advance. So you go to the doctor, and then are left waiting anxiously to see how it will all fall out. Ugh.
And my insurance really is the “best case scenario.” My dad is also a type 1 diabetic, and he runs his own small business, meaning that he has to get private insurance. This is a really, really bad deal for a diabetic. He has to pay nearly full price for his insulin and doctors visits…the insurance pretty much only kicks in if something catastrophic happens.
in the States as well. my tiny strategy is to keep working for huge companies. These companies have decent health insurance, which allows me to do what I need, pay for my supplies with a “co-pay” and with some forcing and threatening, get any high tech equipment such as CGM, Pumps, and whatever I need. I also get to power purchase my life insurance, which would otherwise be impossible for me to get. This helps protect my family. This strategy includes a bucket of luck as it was certainly not all planned out. I simply could not afford to be self-employed unless I had substantial savings in the bank.
compare and contrast as you like, but my effective tax rate is in the 29-32%, and while I do have to pay in to my insurance and I do have copays and deductibles, I also get to take home a bunch more of my salary, compared to some of my colleagues in Europe. perfect system -> Nope, better or worse then “free healthcare” -> unclear.
Interestingly, I also work for a multi national Company, which covers my health insurance. This ensures that 80% of all costs incurred are covered and refundable. Also, with prescriptions, once your family costs reach $125.00,they are free for the remainder of the year. So, generally, NZ is pretty good as far as health care goes.Health care insurance is optional here, and expensive, particularly as we grow older, but I have found it beneficial . Our hospitals are a mixture of public and private. Public hospitals have diabetic clinics,and patients are called in for appointments generally 3 to 4 times annually. This is free, regardless of income levels.
Thank you for the replies!!
How does it work for those who do not work?
Over here in the UK, the way we pay for the NHS is through tax. The advantage of this is that everyone despite their earnings are guaranteed free healthcare(excluding dental care).Yes you we may not take back home more of your salary and everything about the NHS may not be perfect, but the NHS is definitely something the UK takes pride in.
I’m in the US too. I was on small business insurance like cmanton’s dad when I was growing up, but I currently work for the state and have really great coverage compared to most people here, plus I’m still on my dad’s insurance for extra coverage (We can do that until age 26 now because of Obamacare). Mostly I stay on his plan because his company is willing to give me a CGM and mine through work is not. We have to pay a $5,000 deductible before the coverage kicks in for his plan, but with 7 people on the plan we always meet that. I pay $50/month for insulin (just novolog) and then I think strips are $30/month until I meet my deductible (I just met that yesterday so until next January my drugs will be free). I also have to meet a separate deductible for pump supplies (I think 3 months work is $70) and my sensor (I don’t know the coverage on this yet because the insurance company dragged their feet and just finally decided to pay their portion last week. So ya, it’s a bit of a mess, but you get used to it and find ways to make it all work and balance a budget.
My cousin is diabetic and has a variety of other social issues so he doesn’t have a job that has health insurance. He is low income so he is on the state health insurance. In Wisconsin the coverage on that plan is great. My aunt had watched what my parents paid for my supplies over the years and then when he was diagnosed (he was 22 so already out of the house) she found out what he was paying thought the state plan and she was shocked at how low cost it was. That isn’t the way it works for every state however, each state has their own “Medicaid” programs so there are definitely adult diabetics who pay full price if they don’t have a job, or don’t have a job that offers health insurance. If they aren’t eligible for their state’s medicaid, they can buy insurance through the exchanges set up by Obamacare, but the costs tend to be really high, so some choose not to if it’s cheaper to pay for it directly. For retired people (or anyone over the age of 65) the federal government has Medicare which covers many medical costs. You can purchase additional insurance plans if you want to that help with what the original Medicare doesn’t cover, I would assume most diabetics do since everything is so high cost. You could get responses from 100 different Americans and the chances are each of us would pay different prices and have different levels of coverage for doctors appointments and meds. I’m going to school for Public Health/Health Policy right now so I could spend hours explaining the details of medicare and medicaid, but ironically I actually have to go write a presentation on the NHS that’s due in a few hours.
I cant get my sensors for my pump because my insurance wont pay for them. They pay for everything else but the sensors. It was so nice when I had them and now with out them I’m having a harder time with my control. When I go to bed I always have to worry about waking up if my sugar drops. Are insurance in this country SUCKS!
Hello, though I love and am loyal to the U.S., our health care coverage is a little spooky for those of us with expensive and chronic illnesses. In my experiences, I’ve actually been penalized for working too many hours or for receiving too high of a wage per hour. Health insurance plans do not like us. Before I developed Type 1 Diabetes, I could work 2 or 3 jobs and not worry. I didn’t care about medical insurance because I was healthy. Unfortunately, that drastically changed in my 20’s. While others are worrying about how to afford their cigarettes, Saturday nights at the bar or tithing at their churches, Type 1’s here are worrying about how to pay for their insulins, test strips, supplies, maintenance meds and CMG’s…just to stay alive. Oh, and of course their PCP appointments and Endo. appts…and hospital stays. The very first memoir that I read about Type 1 after I was diagnosed was, “Metal Jam”. I ordered it from the U.K. Many of us are very thankful for this website. It’s one day at a time. Wishing you the best.
Hello everyone!! After reading some of y’alls posts, I’m still wondering how some pay for healthcare. My insurance won’t pay a penny until I meet my $5,000 deductible :/ I don’t know what to do. I can’t even afford to go to my regular doctors..