Move to the U.S. for a foreigner with diabetes: how to deal with an insurance?

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Move to the U.S. for a foreigner with diabetes: how to deal with an insurance?


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Old 03-25-2017, 19:09   #1
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Default Move to the U.S. for a foreigner with diabetes: how to deal with an insurance?

Hello everyone.

I'm a new here. I live in Scandinavia and everything here regarding the diabetes is quite simple: I get all supplies for free. It is possible that I will get an offer from one of the U.S. university (I have a Ph.D. degree). So, I started to read about diabetes treatment there. If I understood correctly, all medical care in the U.S. has direct connection with the insurance. I know that university will pay that for me, but I still have some problems with understanding of this system. In particular, how can I know if insulin, supplies for the insulin pump, strips will be covered by the insurance? If it will not, does it mean that I will need to pay the full price? I believe that my questions seem very silly for most of you, but I've never used any insurance in my life...Thank you in advance!

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Old 03-25-2017, 19:12   #2
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Originally Posted by mikael View Post
Hello everyone.

I'm a new here. I live in Scandinavia and everything here regarding the diabetes is quite simple: I get all supplies for free. It is possible that I will get an offer from one of the U.S. university (I have a Ph.D. degree). So, I started to read about diabetes treatment there. If I understood correctly, all medical care in the U.S. has direct connection with the insurance. I know that university will pay that for me, but I still have some problems with understanding of this system. In particular, how can I know if insulin, supplies for the insulin pump, strips will be covered by the insurance? If it will not, does it mean that I will need to pay the full price? I believe that my questions seem very silly for most of you, but I've never used any insurance in my life...Thank you in advance!
There are no silly questions, but the answer depends entirely on the insurance policy you are covered under.

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Old 03-25-2017, 19:28   #3
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There are no silly questions, but the answer depends entirely on the insurance policy you are covered under.
Thank you. So, it means that I need to contact an employer for further information? But let's imagine that my insurance will not cover anything, does it mean that I will have to pay the full price from my wallet or there is some support from the U.S. government?

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Old 03-25-2017, 20:39   #4
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It will require a prescription from your doctor in order for them to consider covering any medical supplies or medications. They won't accept a request directly from you.

What is covered is, of course, determined by the insurance company. I would think a university would have a contract with a good insurance company. You may not have any difficulties.

Some insurance companies only cover certain brands. What you may want to find out is if the brand of pump you are using is something available in the U.S., and if the university's insurance covers it.

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Old 03-25-2017, 20:44   #5
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But let's imagine that my insurance will not cover anything, does it mean that I will have to pay the full price from my wallet or there is some support from the U.S. government?
I don't believe there's any government support here like what you are used to.

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Old 03-26-2017, 08:22   #6
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Thanks, VeeJay. It becomes more clear for me. If I am not mistaken, it is possible that my insurance will cover 100%, but it has to be asked from an insurance company, is it right?
You also mentioned that I have to ask for a prescription from a doctor. Did you mean for insulin or also for insulin pump supplies?
By the way, do you use Accu-Chek pump in the U.S.? Is it possible that an insurance company will pay for a new pump?

Thank you.

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Old 03-26-2017, 13:21   #7
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If I am not mistaken, it is possible that my insurance will cover 100%, but it has to be asked from an insurance company, is it right?
Yes, the doctor has to send a form to your insurance company requesting the pump. Whether or not the ins. co. will cover the pump 100% depends on them entirely.

Quote:
Did you mean for insulin or also for insulin pump supplies?
Both.

Quote:
do you use Accu-Chek pump in the U.S.? Is it possible that an insurance company will pay for a new pump?
I think I have read of folks being on this pump, but not sure.

Now, you understand, I don't have any direct experience with this. I have some understanding of how it works for pumps and supplies because some forum members have described their experiences.

Your employer may be able to give you a copy of the coverage information their insurance company publishes for policy holders (the employee). That should outline what they cover. It may name pump brand(s), what supplies, and type of insulin covered.

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Old 03-26-2017, 17:48   #8
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Quote:
Originally Posted by Cricket View Post
There are no silly questions, but the answer depends entirely on the insurance policy you are covered under.
Quote:
Originally Posted by VeeJay View Post
Yes, the doctor has to send a form to your insurance company requesting the pump. Whether or not the ins. co. will cover the pump 100% depends on them entirely.

Both.

I think I have read of folks being on this pump, but not sure.

Now, you understand, I don't have any direct experience with this. I have some understanding of how it works for pumps and supplies because some forum members have described their experiences.

Your employer may be able to give you a copy of the coverage information their insurance company publishes for policy holders (the employee). That should outline what they cover. It may name pump brand(s), what supplies, and type of insulin covered.
I see...I start to have some doubts if my salary will be enough to live in the U.S. I believe that doctor's visits also can be covered by the insurance?
And one more question...Do I need to visit a doctor every time when I need insulin/pump supplies or the prescription can be given, for example, for a year?

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Old 03-26-2017, 19:11   #9
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Originally Posted by mikael View Post
I see...I start to have some doubts if my salary will be enough to live in the U.S. I believe that doctor's visits also can be covered by the insurance?
And one more question...Do I need to visit a doctor every time when I need insulin/pump supplies or the prescription can be given, for example, for a year?
Again, it depends entirely on your insurance, and it some cases your doctor.

I am not on insulin, but my co-pay for doctor visit is $25 per visit. Initially my doctor had me come in every 3 months or so for a new prescription, but now he writes refills for 6 months. My co-pay for the meds, depends on the prescription as well, but definitely way less expensive than full payment.

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Old 03-26-2017, 20:13   #10
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Again, it depends entirely on your insurance, and it some cases your doctor.

I am not on insulin, but my co-pay for a doctor visit is $25 per visit. Initially my doctor had me come in every 3 months or so for a new prescription, but now he writes refills for 6 months. My co-pay for the meds, depends on the prescription as well, but definitely way less expensive than full payment.
OK, thank you very much, everyone, for your help. I understood that I should contact the insurance company to obtain the required answers. I possibly will come back with more questions later

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