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Diabetes for the Uninsured
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An_240647 posted:
I have a dilemma. I'm 60 years old and have several reasons to believe that I may have contracted Type 2 Diabetes, but it has never been diagnosed. I am currently uninsured but have some hope of being able to obtain health insurance in the near future. However, obtaining such insurance will not be affordable, even if it is even possible at all, if I have to check the box on their application that asks if I have ever been diagnosed with this condition. I am therefore reluctant to see a doctor for any reason that might require a blood test, even at my own expense.

I know that, should the provisions of the 2009 Health Care Reform Act ever actually take effect, a dubious proposition at this point, this will no longer be an issue, but 2014 is still a long way away. I have scoured the Internet for advice on how to deal with this but with only moderate success beyond the obvious nostrums about eating right.

Any suggestions on controlling this without the aid of the great American health care system? I mean, how do I use and read a glucose meter -- is 100 the number I'm aiming for? How far off is too far? What steps do I take to control it (with food, hopefully -- insulin isn't generally available without a doctor's prescription) when it gets too high or too low?

It'd be nice to have this stuff summed up succinctly in a well-written article. Our system of health insurance has left me in something of a bind regarding traditional sources for treatment.
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mhall6252 responded:
Welcome to this site! Let me see if I can offer a few suggestions:

1. Get a meter - the WalMart ReliOn is a good, accurate one and the strips are less expensive than most. Test yourself first thing in the AM with a goal of less than 100. Then test two hours after a meal. If the cost of strips is an issue, rotate which meal you test after...one day test two hours after breakfast, the next day after lunch, etc. Your goal should be less than 140, maybe lower as your diet improves.

2. Start a daily exercise program. Walking is a great way to start and it's free. Start with 30 minutes a day and build up from there.

3. If you need to lose weight, start now. Losing even 10% of your body weight can make a huge difference.

4. Your diet should consist of lean proteins, lots of fresh, non-starchy veggies and fruits, beans, nuts, eggs, and a little dairy. Tofu and cottage cheese are good sources of proteins, too. If you can't do without grains, make them whole grains. Read the labels on bread and crackers and make sure the first ingredient is "whole grain wheat." Stick to small portions of whole wheat pasta, brown rice, barley and quinoa if you can't live without grains. If sandwiches are important to you, try making one with just one piece of bread using the regular amount of meat, cheese, lettuce, tomato and other veggies to make the sandwich more satisfying. Skip the chips and add baby carrots or other veggies as a side to satisfy that need to crunch things.

5. If you are drinking sugary beverages including fruit juices, ban them from your diet. It's better to eat your calories than drink your calories. And it's better to eat a piece of fruit than drink the juice, so that you get the fiber from the fruit. A small orange is signicantly better than a glass of orange juice. Water is important, of course. There is some debate about diet drinks and whether or not they are safe and trigger someone's sweet tooth. Personally, I use diet drinks. Others avoid them like the plague. Do what works for you, so long as you aren't drinking sugar-laden beverages.

5. Read, read, read. A good place to start is Dr. Dansinger's tips on diet and diabetes reversal. You'll find the link on the right side of this page under his picture.

6. Come back and ask lots of questions.

7. Start right this minute! Even if you don't have diabetes, these healthy tips will make a difference in your overall health.

Let us know how you are doing!
Michelle
Diabetic since 5/2001
Follow my journey at www.mch-breastcancer.blogspot.com
Smile and the world smiles with you.
 
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redhawk44357 responded:
hi and welcome, i too have the problem of no insurance. is there a charity hospital system in your state? here in louisiana we do and if you qualify then you can get cut rates on most drugs and testing supplies. the wal -mart tip is a good one. i have the reli-on stuff and its not fancy but it does the job for me.
 
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WoodySmith replied to redhawk44357's response:
See, here's the thing: My inability to purchase insurance may be a temporary state that ends well before 2014 (if indeed 2014 ever comes in the face of potentially successful Republican attacks on civilization). If I go to any doctor, hospital (whether charity or not), clinic, whatever, and he diagnoses me with diabetes, I shall have to check the little box on the insurance company's form asking what conditions have I had diagnosed.

When I check the "Diabetes" box, they will "decline" (isn't that a nice, polite word?) to accept me for coverage in most cases, and those few that do accept me will set their premium rates at a level higher than I (or even most millionaires) would be able to afford. Therefore I cannot even accept a physician's assistance that is offered free of charge.

Only in America!
 
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flutetooter replied to WoodySmith's response:
I understand the problems with a diagnosis of "diabetic". I think that may be the reason why my doctor has "hyperglycemic" (high blood sugar) on all my records. I do know that if you "lie" about a diagnosed condition on an application blank you are in real trouble, but if you really have not been diagnosed, IMO you are telling the truth in not checking that box.

Now -- how to find out on your own and in the meantime work at making your health better. You can actually bring down your blood sugars with correct diet and exercise, so do pursue that goal. Buy yourself a meter that uses testing strips that are less than 50 cents each. No perscription is required. A diagnosis of diabetes starts at 126 fasting; prediabetes starts at 100. However, the morning fasting number is generally the LAST thing to go up, and other tests may show diabetes earlier.

Also an A1c of 6.5 shows diabetes ; prediabetic starts at 5.6, 5.7, or 6.0 depending on the scale used or the doctor. That score shows your average blood sugar over 3 months 24/7. Those numbers will correspond to numbers like you meter readings when you consult a chart. You can also buy, (for about $15 each) an A1c home testing kit from Walgreen's, Target, etc., either Bayer A1c NOW or another kit recently mentioned by David Heuben which he likes better. The directions are good, it doesn't hurt, and that would give you a better indication of whether or not you would test as a diabetic in a doctor ordered lab test, thus affecting your insurance. A doctor would also probably order a glucose tolerance test, in which they give you a liquid sugary drink and then take several blood samples over the next hours to see how your body processes it. There is no home test equivalent to this test.

When you get these numbers, write back to us and we'll give you all kinds of advise on how to lower your numbers--not necessarily to dodge the insurance, but to start a healthier life!!! Good luck. Whatever your reasons are, you are on the right track.
If at first you don't succeed, try, try again!
 
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DavidHueben replied to WoodySmith's response:
Woody, I am 63 years old, retired since 2004, and I have insurance thru the retiree plan from my former employer. I was diagnosed with Type II diabetes in 2005.

I have had to check that "little box" many times since. I have never been denied coverage nor have I had to pay exorbitant premiums. In fact. I pay the same thing as everyone else ($370 per month). That includes medical, dental, and vision insurance for one person.

This year alone, my insurance plan has paid out about $150,000 in claims for five eye surgeries to treat a detached retina. My out of pocket costs have been less than $1000.

For the record, I am anything but a millionaire based on income. Between my IBM pension and Social Security, my yearly income is about $43,000. I do have about $800,000 in assets (my home, investments, and 401-K), but I refuse to touch those until absolutely necessary.

With your references to Republican "attacks on civilization", I can only assume that you are only willing to confront your diabetes when it will be covered on the taxpayers' dime.

DMH
We sleep soundly in our beds because rough men stand ready in the night to visit violence on those who would do us harm.

- Winston S. Churchill




 
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betaquartz replied to DavidHueben's response:
I too am lucky enough to have a coverage through my previous employer-a PA school district. At the same time I am concerned about the position of both parties. We depend on our retirement from the state that we paid into as teachers for over 35 years. We are not in any way rich, but feel blessed in this time of trouble. At the same time I look at the SS system that I have paid into for over 40 years and know that if it had gone the way the Republicans had wanted under the Bush administration by privatizing it that much of the country would be without that retirement aid. I am not looking for a hand out, only for what is right. The health care act is when one looks at the philosophy is right. None of the points in the document can be found fault with philosophically, the administration needs to be tweeked. At this time the inability of congress to work across the isles is problematic. At the same time I can not condone any group of elected officials the will sign a pledge that hampers their ability to negotiate as in the Norquist pledge. Be as it may, I am and will remain a registered Republican-yet embarrassed to admit it of late.
 
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WoodySmith replied to DavidHueben's response:
But you already HAVE insurance through a group plan. You never have to fill out one of those private individual insurance intake forms.

Trust me: For those without insurance who may be seeking insurance on the private market, the situation is very, very different. Health insurers routinely refuse to cover anyone with a prediagnosed condition that might result in medical care payouts that exceed the premiums they collect.

This is one of many ways that the free market badly disserves public needs when it comes to medical care. The normal controls relied upon to keep things in balance via the supply/demand equation simply do not apply to medical care.
 
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WoodySmith replied to betaquartz's response:
Why would you remain a Republican? For one thing, their war on teachers is a war on your own profession. For another, their view of health care seems to be that if you're sick or injured, it's just your own darn fault, and if you can't afford healing, then just do us all a favor and die.

You have the party of Grant, Hayes, Harding, Coolidge, Hoover, Nixon, and George W. Bush vs. the party of Jefferson, FDR, and Kennedy. You have the party of the Great Depression, McCarthyism, Watergate and Iran/Contra vs. the party of Social Security, Medicare, desegregation and women's rights.

But it is health care that right now seems to be a big and possibly growing problem, as insurance companies are jacking up their rates and raising deductibles at unconscionable rates and the Republicans are striving to repeal even those mild regulatory tweaks that Obamacare represents, and if they have our way we may fall into the third world.

Think about it. There are many very good and valid reasons for you to be embarrassed.
 
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soapster1949 replied to WoodySmith's response:
When you get a job, will you be offered insurance which would be a group plan? If so, I don't think you will not be penalized for having diabetes. Group plans aren't as selective regarding pre-existing conditions or rates as a private plan would be.

I would suggest you develop a food and exercise plan that assumes you are diabetic. As Michelle and Flutetooter suggested, you can buy strips and a meter and even an A1C test to verify whether you are currently in a diabetic range. With a healthy diet and exercise plan, you can very well bring those numbers down possibly into a non diabetic range.

Some people who have followed a healthy food plan and exercise plan reach goals which put them in the "normal" range. You could say they are in remission. This may be possible for you if you start now.
 
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betaquartz replied to WoodySmith's response:
The Republlican party of today is not the one I started with, mine was one of Ike, Ford and Reagan. I liked these presidents and believed in them. Today however I don't believe any of them would be nominated to run for the Republican party. They were too middle line. I await the day when the Republicans leave the far right rhetoric behind. It may never come, and I may have to change my mind, but not yet.
 
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DianeR01 responded:
Hi WoodySmith,

You have received some good lifestyle advice. As far as being denied insurance because of having a preexisting condition, this shouldn't be a problem for a group policy. What you may have is an exclusion for a specific condition which has been diagnosed or should have been diagnosed in a reasonable person.

As an example, a month after your insurance kicks in, you have an A1c of 13 at the time of diagnosis and a normal non diabetic range is 4-6 the insurance company could say a reasonable person would be having symptoms by the time their A1c is at 13 and seeking medical care therefore we will not cover diabetes in this individual for a period of time. An A1c that high likely indicates a condition which has not been treated and has been around for a while.

Please remember this is generalized information and your state may have different rules. You may want to contact your states insurance commissioner for more information. Also remember indvidual policies are different than group(employer) policies.

Seeking medical attention now or later is your choice but I would for sure start making lifestyle changes and living life as if I hade diabetes.

hope this info helps.

di
accelerate out of the corners
 
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WoodySmith replied to DianeR01's response:
So you are saying that whether I I have been diagnosed or not, an insurance company can deny payment for care for a condition I "should have known" I have?

I don't think that's the rule, but I wouldn't put it past most of today's increasingly cruel insurance companies to make it so, either by influencing the rulemakers or merely denying the claim and making me put up a legal fight for it, hoping that their superior legal resources prevail at least to the point where I give up.
 
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DianeR01 replied to WoodySmith's response:
Woody,

Yes, that is exactly what I was saying, an undiagnosed condition may be excluded from coverage even within an employer policy. This is assuming you have been uninsured for more than 60 days. Less than 60 days the exclusions do not normally apply. While I don't believe it is the law, the law allows insurance companies to do this. Again, your states insurance office may be able to help more.

The key with health insurance is to not go more than 60 days without, at that time your rights change in most states.
accelerate out of the corners
 
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laura2gemini2 replied to WoodySmith's response:
As of right now the states are required to offer insurance for those with pre-existing conditions. Maybe you should apply for a state funded insurance policy?


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