This is a guest post by Regina Shirley, registered dietitian and diabetes blogger at
As an insulin sales rep for two years and a pump/CGM sales rep and trainer for over five years, I learned more than I ever cared to know about the ins and outs of diabetes technology. I spent years becoming an expert on deductibles, insurance policies, what goes into research and development of new products, FDA red tape, diabetes software, and adult-learning principles for every patient that I ever put on a new product. Each time a new product hits the market, or rumors flare with the birth of a new idea for a new product, it is Christmas for people with diabetes. Although there is promising research for a cure somewhere on the horizon, we can’t touch it or see it. So, when a new product emerges that can make this disease a bit more entertaining and possibly even a bit easier to manage, we jump at the chance to be one of the first to try it out.
Often times, we let our pancreases do the thinking and not our brains. We automatically assume because it’s ‘new’, that it is meant for us. This is not always the case. Here is a list of questions you should ask yourself, your Endo or CDE, and your insurance company before reaching into your 401-k to get the latest and greatest:
- How long has the product been on the market and what do the unbiased reviews on the web say? (Broken Pancreas is a perfect example of an unbiased view, as Ken has no connection or tie to any one particular diabetes company).
- A good rule of thumb is to wait a year before buying a brand new diabetes product to allow the company to work out any manufacturing or insurance coverage kinks. I know it is difficult to be patient, but it will help you to avoid accuracy issues and potential billing issues. This doesn’t go for all products, particularly I would say wait on the more expensive devices.
- What company is producing the product? Have they been around for many years with other tried and true products or are they a start-up company that may disappear in a year leaving you with an expensive product and no supplies?
- Is this the first-generation product of its kind? If so, I can almost guarantee you that the second generation is right around the corner and the company just wanted to get product moving off the shelves.
- Make sure to ask questions about trade-in value should a second-generation product come on the market before your insurance will cover a new one.
- Make sure to ask if the sensors or test strips will indeed be compatible with the future generations of the product.
- Always ask about warranties! Most products come with one, but you would be surprised how short some of them are!
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Call your insurance company to double check what the device rep or company is telling you.
- The customer services call-centers that most of the device companies offer to check into your insurance are sometimes not as experienced as a tenured rep. They have to read off of a script and give you estimated quotes depending on what your general insurance carrier usually covers. They are pretty good about verifying coverage and then calling you back with a fairly accurate estimation. But you must be your own advocate! Once you get the estimate from the device company, call the insurance company yourself to verify any hidden fine print.
- Ask the insurance company questions like:
- What is my annual out-of-pocket maximum or deductible?
- What is my pharmacy co pay and are the supplies (pump, CGM or test strips) covered under pharmacy or durable medical equipment (DME)?
- Do I have a DME Cap? This means if your DME cap is $3000 and a pump is $5000 you are left with a $2000 out of pocket expense. If you have a $500 deductible, than at least paying that $2000 up front (or on a payment plan) will help you to meet that deductible right away, thereby helping absorb a co-pay on supplies (but always ask about co-pays on supplies to make sure).
- If you can hold off… wait until the end of the calendar year to purchase your new device. This way you have most likely met any large deductibles that you may have, and the device will essentially be free or less expensive.
- Finally, ask yourself the following questions:
- Will this device help me reach my blood sugar and diabetes management goals?
- Do I really need it, or am I doing just fine with my current regimen?
- Am I being pressured by my doctor, device company or family members to get it?
- Does the benefit outweigh the cost?
- Am I going to use this new device as a crutch so that I don’t have to test my sugars as often or so that I can let it take over my diabetes for me? If you answer ‘yes’ to this, take 10 steps back and hold on to all your monopoly money.
- What methods am I using now to log my blood sugars and insulin dosing… is this just one more piece of software that I need or will it truly benefit me because the other methods are not effective for my needs?
Taking the time to research your options and understanding the major benefits of a new cool device will help you be more successful with your diabetes management and your budget.