It’s late Saturday night and you hear the dreaded words, “I’m out of testing strips,” or “My insulin pen is empty.” If you have ever lived with someone managing diabetes, you know that one of the greatest challenges is not running out of critical diabetic supplies.
While many other factors affect diabetes self-management, including a healthy diet and a physically active life, having diabetic supplies on hand is a constant. Most people will count – for the rest of their lives – on testing supplies to ensure their blood glucose levels are staying normal, or on medication of some sort to correct them. Finding a reliable solution to having glucose monitoring devices and insulin delivery devices when you need them is the best place to start.
The older we get, the higher the risk of being pre-diabetic or diabetic. In fact, more than one in five seniors deals with diabetes. Depending on the stage of the disease, different medications and supplies make up part of ongoing treatment. Many of those supplies call for a doctor’s prescription.
For seniors with diabetes who have not yet reached Medicare age, or are not yet signed up for Medicare, the cost of supplies will have to be covered either by a healthcare insurance policy or by out-of-pocket cash. For seniors signed up for Original Medicare Part B (Medical Insurance) or a private Advantage plan (Part C), plus an optional Medicare Part D (Prescription Drug Coverage) plan, those costs will be partly covered by those insurances.
For those over 65, products can be purchased from a variety of sources, including local pharmacies enrolled with Medicare and online suppliers that have aligned themselves with Medicare’s National Mail-Order Program. Medicare has stepped in to standardize the purchase of diabetes testing supplies because those supplies represent a considerable expense: the average person with diabetes will spend over $13,000 per year on health care expenses, according to the American Diabetes Association. It makes sense to allow Medicare, or your independent health care insurer, to shoulder part of that cost.
Whether Type 1, Type 2 or Latent Autoimmune Diabetes in Adults, diabetes can develop gradually, which can make it hard for us to recognize the symptoms. As a result, we may already have some of the short-term and long-term complications by the time diabetes is formally diagnosed.
Short-term complications are very low blood glucose and very high blood glucose. Long-term complications are microvascular and macrovascular, which means they affect the small and large blood vessels related to the eyes, kidneys, nerves, heart, gastrointestinal tract and brain. In short, uncontrolled diabetes can take a toll on virtually every organ in your body.
Getting control over our blood glucose level is critical to preventing these complications from the outset – or keeping them from worsening. To do that, finding an obstacle-free and affordable source of diabetic supplies is vital.
Finding the right solution for diabetes supplies means:
- Having the tools to keep our blood glucose levels within the safe range;
- Not facing the dangerous highs and lows, if we run out of supplies;
- Avoiding damage to our eyes, kidneys, nerves, gums and teeth;
- Reducing the likelihood of triggering heart disease or a heart attack; and
- Staying active and enjoying life by avoiding the side issues that can come from uncontrolled diabetes.
In short, staying on top of your blood glucose must be an integral part of your routine, so the easier you can make it, the better.
Among the most useful sources of diabetic supplies are online companies with whom you establish a relationship and who ship your needed supplies automatically, so you never run out.
As you compare the different companies, you want to compare their costs for the exact supplies your doctor has recommended to control your diabetes. You then want to know what warranty is offered and how easy the company is to deal with regarding ordering, shipping, billing and possibly canceling orders. The access to the company’s customer service representatives also plays a role.
One important qualifier is that some online companies bill insurance companies directly and cannot work with you if you have no insurance. If you can work with them, having access to a 24/7 website for ordering and billing is useful, as is a sampling policy for some supplies. Then, because diabetes supplies can be expensive, you want to know about payment plans and shipping charges. Lastly, you want to know how fast they ship.
The four keys to controlling diabetes are eating healthily, staying active, checking glucose levels regularly and never missing a dose of medication. The last two can be affected by the reliability of the diabetic supplies provider you select.
Where you purchase your diabetic supplies will be determined partly by what kind of insurance you have if you have it.
If you have no insurance, the price will be your primary consideration, and you will want to do serious comparison shopping between brick-and-mortar pharmacies, ‘big box’ retailers like Walmart and Costco, online pharmacies and any other resource you can find. However, also consider that you will need your supply to be ongoing and reliable, so the decision you make should not put your health at risk.
If you have health care insurance from a private insurer, you will want to identify what diabetic supplies providers are approved by your insurer. From there, deciding factors will be price, convenience and whether they carry your preferred brand of products (such as your glucose meter and testing strips).
If you are over 65 and have Original Medicare Part B, your supplier will have to be a ‘contract supplier’if Medicare is going to help pay for diabetes testing supplies, whether you use a national mail-order contract supplier, local pharmacy or storefront supplier. Medicare Part D (Prescription Drug Coverage) covers specific insulin and insulin-administering supplies similarly.If you are enrolled in a Medicare Advantage plan (Part C), your plan will advise you of available suppliers.
What you will need: the type of diabetes you have will determine the supplies you need, but the basic list can include:
- A glucose meter (or a continuous glucose monitor);
- Test strips for use in meters;
- Lancet devices and lancets to obtain a blood sample from your finger
- Glucose control solutions;
- Insulin pump and pump supplies;
- For type 1 diabetes, urine test strips to measure ketone levels; and
- Insulin and medical supplies to administer it.
Many other supplies may make your shopping list, depending on how you and your doctor have designed your treatment protocol and what your doctor has prescribed.
Where to buy them: As the diabetic population grows, more and more sources are popping up to sell you the needed supplies, most of which must be purchased with regularity and for a long time. Many of the online sources are reputable and reliable, but some are not.
It is essential to research the company carefully, to be sure that the supplies you receive will be fresh, not near expiration date, correctly handled and not malfunctioning. (Some discount companies purchase overstock inventory from pharmacies, for example.) You should also never accept items you did not order: refuse the delivery or return them and notify your insurer.
Look for companies that have ‘special pharmacy’ services, so one provider can offer one-stop shopping by providing both your standard diabetic supplies and your prescription drugs.Auto-ship programs are another valuable convenience, as they ensure you do not run out of critical supplies because you forgot to reorder.
It is also beneficial if a company has in-house diabetic experts who can help set you up with diabetic supplies, plus insurance experts that can help explain your coverage – whether with a healthcare insurer or Medicare.
Two areas differentiate what seniors prioritize from what younger people do when making such purchases: age-friendliness and health-related value.
Agefriendliness: Your age should not affect your interaction with a diabetic supplies provider unless it is wholly internet-based and you become uncomfortable going online. Once you develop cognitive issues, using such a service could become a barrier. However, because of how critical it is to take diabetes medications consistently, you will likely have transferred the ordering responsibility to someone else anyway.
Health-related value: Whether your health is declining due to diabetes or other illnesses, your energy level may be diminishing, and your mobility may become more limited. In either case, being able to receive your vital diabetic supplies at home means not having to deplete your energy or leave your home. That is very valuable.
Diabetes is a costly disease to monitor and manage when you consider the cost of testing supplies and other medical expenses. If resources are limited, and you have no insurance, it is critical to identify governmental and nongovernmental programs that might be able to help you.
While a glucose meter is not a frequent purchase and can often be found at a discount, the significant cost in managing diabetes is in purchasing the test strips for the meter. Depending on how often you test your blood sugar each day (anywhere from one to eight times), if test strips run $0.35-$1.00, their monthly cost can add up quickly. Besides that, you have the cost of lancets, plus insulin and its administering supplies if you are insulin-dependent.
If you are insured, the crucial part is how much your insurance company covers. With healthcare insurance policies, you will have to confirm that a supplier offers the brand covered by the insurer, so it does not become an out-of-pocket expense.
If you are on Original Medicare and are buying from a ‘contract supplier,’ the company cannot charge you more than any unmet portion of your Part B deductible and 20 percent coinsurance.(It can also not pressure you to switch product brands.) Local stores that accept Medicare assignment are under the same constraints. However, if you are on a Medicare Advantage plan, as those are private insurance plans, your out-of-pocket costs will be determined by the insurer.
Choosing a diabetic supplies provider will depend on the out-of-pocket cost, the company’s warranty, how easy it is to use the ordering service, its cancellation policies and its customer support.
Price: Comparison shopping is essential for diabetic supplies, especially since you will be reordering them with regularity for a long time.Whether you have insurance – and what insurance you have – will determine how much you will be paying out of pocket.
Warranty: A good company will warrant its product. With something as sensitive as diabetic supplies, where tainted or damaged goods could have severe implications if used by a person with diabetes, extra care must be taken, and a company should be willing to take back anything that is suspect.
Ease: Most diabetic supplies will be needed for life, so it would be natural to want to establish a long-term relationship with a supplier. However, a company must earn that relationship. How easy the company makes it for a diabetic customer to receive supplies, including with reliable auto-ship programs, is the very first step. Products should be shipped promptly, and transit times should be reasonable.The company’s website should be easy to navigate, and the ordering and billing process should be trouble free.
Cancellation: You may have to cancel or postpone an auto-ship delivery if your inventory gets out of balance or your medication protocol changes. You want to know how straightforward and transparent the cancellation process is, so you do not end up having to return an inconvenient delivery.
Customer support: Diabetes is a worrisome disease because of the level of vulnerability it can create if not well managed. Easy access, good communications and knowledgeable representatives give diabetic customers the support they are seeking. The company should provide many ways to communicate and extended business hours.
When sourcing diabetic supplies, some seniors are confused about what Original Medicare and Medicare Advantage plans cover.
According to Medicare literature, “Medicare Part B covers blood glucose monitors, blood glucose test strips, lancet devices, lancets, and glucose control solutions for beneficiaries with diabetes, whether or not they use insulin, but the amount covered varies.” It also covers “insulin pumps and pump supplies (including the insulin used in the pump) for beneficiaries with diabetes who meet certain requirements.” In 2017, Medicare also started covering “continuous glucose monitors (CGM) that are classified by Medicare as ‘therapeutic CGMs.’”
That means that no matter where you purchase those supplies, if you have Medicare Part B and the supplier is a Medicare ‘contract supplier,’ you will be covered. If you are considering an online supplier, that is the first question you want to ask.
Medicare Part D offers prescription drug coverage. Because insulin is a prescription drug used in controlling diabetes, it is covered by Medicare Part D (unless it is being administered with an insulin pump, in which case it is covered under Part B as durable medical equipment). Part D covers other drugs you might need to control diabetes, as well as “medical supplies needed to administer insulin, such as syringes, needles, alcohol swabs, gauze and inhaled insulin devices.”
You must have the government’s Medicare Part B or a private Medicare Advantage plan to qualify for Medicare Part D, which is issued by private insurers. With Part D, whether you purchase at your local pharmacy or decide to use an online supplier for convenience, your specific coverage will depend on how your chosen Part D provider classifies different drugs. Before signing up with a Part D insurer, you want to ask if the prescription drugs you take are on its list of approved drugs and how much the drugs will cost you.
Your primary goal should be to find a simple, reliable and affordable solution to obtaining all your diabetic supplies. By doing so, you can integrate them seamlessly into your everyday life and focus all your energies on living it to its fullest.