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Reflections on a Medical Management Program

The Cost of Care

About a year ago I discovered the Medical Management program offered by my local hospital. Diabetic supplies are not cheap even with good health insurance, so I accept all the help I can get. Before this program, I paid $20 for a 20-day supply of insulin ($1/day). Through the medical management program, I get a 90-day supply of insulin for $40 (saving me a little over $200/year). I also spend $30/month on insulin pump supplies and around $500/month for my CGM. This particular medical management program does not cover my pump or CGM supplies at this time, so I will take what I can get with the discount on insulin. Given that my insurance deductible is $6,000, I pay out of pocket for all of this until about October. November and December are my favorite months of the year because I get the majority of my medical supplies for “free.”

All of that to say, “Every little bit helps.”

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If you’re unaware of similar medical management programs in your area, I encourage you to explore them. These programs often offer more than just medication assistance, catering to a range of medical needs within families. Even though my story doesn’t end great, these programs have their place.

A Bumpy Renewal Process

Recently, there was a hiccup in the program’s renewal process, leading me to another clinic associated with this same program. While I am grateful for the opportunity to continue receiving affordable insulin, the process left me scratching my head in confusion. Because of this “hiccup in the system” I had to drive an hour for my annual review. I guess they have to confirm that my chronic disease is still costing me money.

During the appointment, I was asked five questions and then sent home. These are the 5 questions…

  1. What medication do you use?
  2. Do you have any reactions?
  3. How do you monitor your glucose?
  4. Do you experience low blood sugar?
  5. Do you have a follow-up appointment with the pharmacy?

No one checked my ID or my vitals – the minimum requirements I thought were needed to require an in-person medical appointment.

This could have been an email, a text message, a virtual visit, or a phone call to save time and resources for both parties involved.

I am thankful I had the flexibility in my day to miss 2 hours of work and a reliable car to get me to the medical facility – luxuries that I do not take for granted. But many others need this program far worse than I do and do not have the mental faculties or resources to navigate these cumbersome systems. The healthcare system is so broken.

While I appreciate the efforts made by healthcare providers to ensure patient compliance and engagement, there’s room for improvement in streamlining administrative tasks. A more efficient system could optimize resources and efforts.

Unfortunately, this story does not have a happy ending. Even after jumping through all of their hoops, the new team doing my medical management messed up my prescription at the pharmacy and I am back to paying $1/day for insulin until they can correct it.

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