January 14, 2021

Diabetes and Benefits


In Spring 2003 I started struggling with tiredness, unquenchable thirst and frequent trips to the bathroom.

Uncertain why this was happening, I sought medical treatment and received disappointing news – I have Type 2 Diabetes.

My journey for health was just beginning.

Dealing with Diabetes

I learned more about the disease and how to manage it from my medical team.  The disease is certainly not a death sentence if you comply with medical advice from your physicians. I had to learn how to monitor my blood sugar level, and how to inject my medication while taking two oral medications daily.

Exercise and diet are critical to achieve good control of my blood sugar levels, and my weight loss has reduced the amount of medicine I take over the years.

Managing the disease takes commitment and discipline.

Linking Diabetes to Insurance Benefits

The same can be said for managing the high cost of the medications needed and navigating your medical insurance benefits.

I have a high-deductible medical plan with a health savings account through my employer.

Here are a few lessons and tips I can share to help mitigate the impact of expensive medications and supplies for Diabetes:

• Before I meet my deductible during the plan year my prescriptions cost full price minus the insurance discount.
• I fund my health savings account with larger payroll contributions at the beginning of the year to pay for this larger expense.
• I keep my annual contributions below the IRS allowable maximum contribution amount for health savings accounts.
• The 2021 IRS guidelines are Self-only: $3,600 Family: $7,200.
• HSA catch-up contributions (age 55 or older) is $1,000. You can calculate the payroll contribution amount by the number of pay periods your contributions occur. In my situation it is 24 pay periods.

Ways to Reduce Costs

The other strategy I used with the help of my employer Apex Benefits, was to cut the cost of the medicine.

There are many prescription advocate services available for this and many hospital systems have a drug price reduction program as well. I pay $60 per month for my program, and they secured drug company grants and discounts for me. Many of my medications were free, and the others were heavily discounted for the year.

I saved more than $2,000 on my prescriptions for the plan year. I received this even though I had commercial medical insurance through my employer. These prescription advocate programs also offer their services to self-funded employer groups, not just individuals.

Managing the disease and the cost takes some effort, but it more than pays off.

My blood sugar levels since 2003 are considered well-controlled by my internal medicine provider that helps me monitor and manage my diabetes. I currently show no complications from the disease.

For more information on ways to cut high Rx costs and help your employees stay healthy, feel free to contact Apex Benefits.