Affordable and adequate health care insurance is critical for people with diabetes. Yet a significant portion of adults and children with diabetes are underinsured or uninsured. People may have to choose between their health and paying the bills or putting food on the table.

One change that will impact diabetics that receive Medicare goes into effect on Jan. 1, 2023. It forces Medicare to cap the price of insulin at $35 per month. That’s good news, but it doesn’t reduce the cost of test strips and other supplies diabetics require. Neither does it affect anyone with traditional insurance.

Insurance coverage of diabetic supplies varies wildly among insurers. Diabetics that work are still at the mercy of employer-provided insurance coverage that can charge virtually any amount of co-pays they want and pass the majority of the cost for diabetic supplies on to the patient.

Coverage through the Affordable Care Act, also known as Obamacare, can be obtained at the Healthcare Marketplace. There are plans that have no monthly premium if the applicant qualifies and they cover diabetic supplies. However, the deductibles are typically so high – up to $5,000 or more – that the average person is still shouldering the entire cost of their insulin and other diabetic necessities.

Medicaid helps low-income households with medical costs, providing individuals meet income eligibility guidelines. They may have deductibles, also called spend-downs, that run into thousands of dollars before Medicaid will pay for any covered expenses.

Diabetes has multiple ways it affects the body. Depending on how well the disease is controlled and how long the person has been afflicted will have an impact on the healthcare services a person will need. Each person must evaluate their current and ongoing healthcare requirements to locate the insurance company and policy that best meets their needs now and in the future.

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