I want to preface this blog by stating it is not a slam at providers or vendors, but I do want to illustrate how ineffective our healthcare system has become. Too many rules, too many silos, and insurance companies really dictate care more than providers. It is upside down. It is not for the faint of heart and is a major barrier to wellness. It’s time for something new. I shared my journey on my social media sites and am recapping the story here.
I have had Type 1 Diabetes for more than 30 years and on an insulin pump for over 20. I’m an RN. I know the system. I needed a new insulin pump and I wanted the large out-of-pocket cost to apply to my deductible, so I waited until Jan 1, 2022 to start the process.
I booked an appointment with a wonderful Family Practice Nurse Practitioner in February (Thanks Heather!). I really just need the prescriptions and order for a pump. I have been adjusting my own settings for decades and the pump reps are really the experts when you need to make changes or have questions. She was willing to do this for me, but upon review by the physician that oversaw the practice, it was determined that they weren’t comfortable with me taking care of myself. I needed to see an endo.
To the portal I go to find an endo that is on the plan. Turns out all the “good ones” don’t take the ACA plan I am on. I know the “good ones” because the T1D community is pretty tight and we share a LOT of information. So my next option, is who can see me the soonest. The soonest new patient appointment I could get was 6 weeks later. I was going on a hope and a prayer that my very old insulin pump would hang on. My saga began here.
March 22nd post:
“One of the most frustrating aspects of living with #diabetes is jumping through all the hoops required by insurance. I loved my previous provider, but they don’t take my new plan. I am no longer on a family plan since I got divorced and insurance options for a single person with T1D are limited.
So this is the doc I will have to use. TBH, it sucks! Still, I remember, that I get to choose. Even though it’s a pain, I get to come here. I get to tell my story and convince this new provider that I know what I am doing. It is the door I must walk through to get a new pump (my current one is out of warranty).
So I will choose to be kind, to play the game, to negotiate for what I need, and to walk out that door in an hour with a provider who had the opportunity to hear me, I will have listened to them, and a prescription for a new pump and CGM. And then I get back to living my life, grateful for the juice and technology that keeps me going!”
Afterthought: The visit was brief and he promised to send off orders to Omnipod right away. My biggest curiosity was that he didn’t even ask about my pump settings. They didn’t have the software to connect to my pump, so they just skipped it. I (wrongly) assumed the order would read “continue previous pump settings”.