Does anyone work for the Federal government and have recommendations for best plans for T1D? Thanks!
Hi Meredith-
I can’t make recommendations among the various carriers since I am not familiar with all of them. However, I have some recent experience with BCBS FEP. Last year I was on their Basic plan. In early December I was diagnosed T1D. I discovered that the BCBS Basic plan does not cover my insulin- Humalog & Lantus. Fortunately this was during open enrollment. I switched to BCBS FEP Standard plan for this year. My Humalog and Lantus are $40 each for 90 day supply through the plan’s mail order pharmacy- CVS Caremark. I just ordered a Dexcom G6 through the mail order pharmacy, as well. Prices for sensors are $125 for 90 day supply. Transmitters are also $125 for 90 day supply. Receiver is $125. Strips, lancets, and pen needles are generally cheaper at retail pharmacy rather than mail order pharmacy. The Caremark website has a search feature to look up and compare prices among pharmacies, but it seems to be frequently out of order. The customer service people at BCBS FEP are great. Hopefully some more federal employees can share information about other plans.
Hi @rrhrachel . I just wanted to share that I use Goodrx to compare prices at my local pharmacies, and there are probably others you can try if you need.
@meredithJDRF you might want to connect with an insurance broker. I would imagine they can filter by federal plans to help you compare.
I am also seeking this information and would like to have a good idea before open enrollment.
We have GEHA Standard which we’ve had and loved for many years. Now that we are dealing with a new T1D diagnosis, its been challenging to say the least. We have Novolog and Tresiba, novolog has a $25/month discount card, so that is what we pay, and Tresiba is $24/month. We do not have GCMs through pharmacy and have to go through DME companies. Dexcom was a $500+ copay (15% of negotiated rate) for 3 months with Edgepark, but was $289 for 3 months through VGM homelink.
Side note: It is impossible to compare DME companies because they all have their own negotiated rates and they won’t share those with you until you’ve fill the RX with them. We have switched to the Freestyle Libre2 due to my daughter’s preference (Dexcom was too painful at time of insertion), and it is $89/3 months with my insurance.
We’ve had to fight insurance and pharmacy along the way, but finally feel like we are getting a handle on all of this. I hope others reply with their actual costs because I fear otherwise there is no way to truly compare plans and costs for T1Ds without actually signing up for the plans.
Hi @JnHarmy . When it comes to my DME I’ve always worked with the rep assigned to my endo’s office. I’ve found them to be knowledgeable about which companies work with my insurance, and their reputations for customer satisfaction. I was with my former supplier for so long I don’t recall doing comparisons among companies - I think I took my pricing from my policy guidelines and assumed it was the same regardless of supplier, although perhaps that’s not correct - and I’ve always been with private industry, not the federal government, which might make a difference.
However I have found the hard way that it’s worth having my device rep do the legwork and paperwork with them rather than going on my own with the different suppliers. It may be worthwhile having them confirm the pricing too.
PS - during open enrollment I would check out the rx formularies for the various insurers. They had different tiers of pricing which determined cost for each drug.