New to Insurance? Here Are Some Tips!

February 22, 2021
Jonathan Giffin
Jonathan Giffin, born and raised in the town of Rutland, VT, has been a Type 1 Diabetic since just after his first birthday. Since completing his bachelors degree in psychology from the University of Massachusetts Amherst in 2017, he has periodically worked as contractor for large biopharmaceutical companies in the greater Boston area as a technical writing professional. He currently works at Fresenius Medical Care as a Quality Systems Coordinator. He enjoys discussion, debate, and a good cup of coffee. During his free time, you can find him reading or writing, practicing his violin, pushing himself at the gym, volunteering for an English language nonprofit - with goals of breaking into the world of education management or entering the political sphere.

When I turned 25 in early January 2020, I knew that in 365 short days I would no longer have the luxury of my parents’ health insurance. At that time, my employment contract had been preemptively terminated and leaving me at that point unemployed for three months. I had loans, a car payment, and rent to pay. The possibility of having to navigate paying for health insurance on top of all that was an overwhelming thought. I had a few short months to find a viable path forward to maintain my financial, personal, and professional future.

The first step was to get a job that would both strengthen my resume and compensate me enough to pay my bills. Against my better judgement, I decided to take another contractual job.

“Any T1D knows that health insurance is arguably the most important perk when deciding whether or not to take a job.”

Any T1D knows that health insurance is arguably the most important perk when deciding whether or not to take a job. Although contracting is great way to get experience in a short period of time, health insurance coverage -if it’s offered at all- is typically very minimal and very expensive.

After six months, my manager informed me that I would be brought on full-time. I received the Insurance packet in September and selections began in November.

Whether you’re currently employed, a contractor, or unemployed here are a few tips I learned as a T1D that might help you navigate the Health Insurance marketplace as a T1D:

It probably goes without saying, but it bears repeating – as a T1D, you have to be your own advocate. You have to reach out and ask your questions; there’s not going to be someone from the organization that will actively follow up with you to make sure you understand. You may receive a benefit packet that details your options from a broker or insurance company, but that’s typically where the help ends – unless you reach out. By being proactive, you can get the answers you need about the different coverage benefits/prices for the overall plans – or investigate what is specifically covered under your insurer’s various plans.

“By being proactive, you can get the answers you need about different coverage benefits/prices.”

Ask the question. To piggyback on #1: don’t hesitate to ask whatever questions you have, even at the risk of sounding stupid. There are people who are paid to answer your questions about health insurance. Even if you think you know the answer, it never hurts to confirm that you correctly understand the insurance policy. For instance, I reached out to: my company’s HR representative, medical device supply companies, nurse practitioners, and corporate health insurance representatives to answer a wide array of questions that I had. Even if they couldn’t help me immediately, they were able to point me in the right direction.

Do your own research. Once you receive your insurance packet, start reading immediately! Insurance information is very rarely written in a straightforward and easily digestible way, so you will want the work from step #2 to inform your own research here. For instance, you should figure out how Durable Medical Equipment (DME) is covered in various policies – and which medical supply companies will take your insurance. For medication costs, you can ask for comparisons between generic and brand name. Therefore once you know the cost of your medications and DME, you can create a pretty comprehensive cost analysis.

Consider your career prospects. Different fields offer different levels of financial and/or insurance stability. For example, an average software engineer will likely have more career stability – and, thus, more stable insurance coverage -than your average musician – who may rely mostly on freelancing and contract work. I’m absolutely not saying that anyone who wants to pursue a career as a musician or artist shouldn’t do so just because they’re a diabetic! It’s simply to your benefit to consider how you might pay for insurance out-of-pocket when your insurance coverage isn’t reliably tied to a single employer.

See if your company/organization has a diabetes support program. Some larger companies and organizations are starting to create support programs that allow employees with diabetes perks like free/ reduced prices on supplies or a reimbursement for physician visits. It never hurts to ask!

Prepare for the worst-case scenario. My mother has a great saying, -“Don’t worry about the worst-case scenario, because what you often worry about usually never happens.” However, since I’m a bit of a cynic, I’m always preparing for the worst-case scenario. You can be employed on a Monday and unemployed on a Friday! As a T1D, it’s important to be prepared for these types of situations. Buy supplies in bulk when you can. If you’re stocked up on supplies, buy more when your prescription refill is available just in case. My rule of thumb is to try and have three months of supplies on hand for emergencies. Also, Know what options are available to you through government programs like Medicaid. Finally, try to build a cushion into your budget that is intentionally high. If you do have to pay for your insurance out-of-pocket for a period of time, this will allow to have an approximate estimation of the monthly cost. ​​​​​​​

Navigating the health insurance landscape can often seem overwhelming. There’s so much variation in coverage between different organizations and plans, with no way to capture every detail in each available plan at every company. However it’s my hope that the tips I laid out might serve as a general guide to help those new to the health insurance marketplace. Health insurance will never be a fun topic, but it doesn’t have to be scary either. It may take time to learn all the ins-and-outs of the various policies available to you, but you can do it! Take a deep breath, settle in, and get ready to read. You will get through this, I promise!

Thank you to the sponsors of our insurance initiatives!

Gold Level: Novo Nordisk

Silver Level: Lilly Diabetes, PhRMA, and Sanofi

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