Test Your Knowledge

The rules regarding health insurance coverage have grown increasingly complex over the years. Patients with diabetes should ask the appropriate human resources professional about the following aspects of their care:

• Co-pays and deductibles. What are the out-of-pocket costs to patients, and how do they differ when visiting in-network or out-of-network physicians?  What coverage is provided for eye care, foot care and dental care? 
  
  
• Diabetes education and associated care. Does the patient’s insurance coverage include diabetes education, weight-loss and fitness programs and counseling with registered dietitians? If these aspects are not covered, can they still be applied to any deductibles?
  
  
• Supplies and equipment. Are glucose monitoring equipment, test strips, syringes and drugs such as insulin, glucagon, antidiabetic agents and antihypertensives included? Is there coverage for an insulin pump, insulin pen, jet injector or inhaled insulin and related equipment? What about diabetic footwear or other recommended equipment?
  
  
• Mental health counseling. Are visits to therapists and diabetes support groups covered?
  
  
• Pre-existing conditions. Patients with diabetes should ask how this condition will affect their coverage when joining a health insurance plan.
  
  
• Diabetes issues related to pregnancy. Pregnant women who have diabetes must see physicians more frequently and have additional tests when compared to nondiabetic women. Patients should ensure the insurance plan will cover this extra care.
  
  
• Surgeries and procedures. What coverage may be available for a pancreas transplant, kidney transplant or other organ transplant? What about experimental treatments such as an islet cell transplant or implantable insulin pump? What sort of inpatient and outpatient rehabilitation is available if a foot or leg amputation or other surgery is needed?