8 Things I think I think.

With an affectionate nod to Peter King at Sports Illustrated, who in his Monday Morning Quarterback blog has a feature called Ten Things I think I think, I’m doing the same thing minus two. Hey man, I don’t do this for a living. If you want two more, you’re gonna have to pay me.

1. If all insulin pump warranties are for four years, and Medicare is a little over 12 years away for me (2027), do I want to get a new pump now— so I don’t have to get one until 2030, late in my third year on Medicare (2014, 2018, 2022, 2026, 2030); or do I wait until after my next birthday, which means I would have to go to a new pump on my first year on Medicare (2015, 2019, 2023, 2027)?

2. I’m wondering why, when I already have my brainpower sapped by managing my diabetes every day, I’ll have to decide from a complicated system of 4(+) Medicare options to make sure I’m covered for whatever comes up. Who designed this and thought this was a way to reward seniors for contributing to society for 65-plus years?

3. I’m worried that as a result, once I become Medicare eligible, I’ll probably just choose the first plan that covers my pump and ignore everything else.

4. I really don’t have to worry about all of this, because if the “experts” are correct, diabetes will be cured by then and I won’t even need a pump in five years (or less).

5. If only.

6. I’m pretty sure that first thing is the longest sentence, like, ev-er.

7. That fifth thing is the shortest.

8. Damn, that’s a lot of pumps.

Comments

Scott E On November 10, 2014 at 1:08 pm
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1. Who knows what will happen in 12 years? Maybe some new tech will break the cycle, or warranties will run for 6 years, or Medicare eligibility will be changed by a few years. But, all other things being equal, I say you make your eligibility for a new pump just BEFORE you switch. Then, at that time, you can decide whether or not you want to get one on your employer-sponsored plan, or if you wait a month or two and get it on a Medicare plan– whichever is better at the time.

2. Someone, somewhere, ingrained the thought in our culture that “choice is good”, so they “reward” you with as many as possible. In reality, all this does is defer the task of developing good healthcare plans from those paid to do so to those who have nobody else to pass the buck.

3. That’s probably the choice I’d make (again, assuming pumps are still the “en vogue treatment at the time).

4. If five years of intense worry can be made pointless by the discovery of a cure, I’m OK with that.

5. Mmm-hmmm.

6. I’m sure the sentences describing Medicare’s coverage exclusions are longer.

7. Yup.

8. You’ll have accumulated plenty of backups in case #1 doesn’t pan out as you hope.

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- StephenS On November 10, 2014 at 1:50 pm
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  Love these responses! Thanks Scott
  
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Laddie On November 10, 2014 at 4:02 pm
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I think that you’re thinking about Medicare way too early and wasting brain cells now that may be needed more in twelve years when you have to start dealing with Medicare. I hurried my pump decision in the fall of 2012 because I wanted to be able to purchase one more pump before I reach Medicare age in 2017. (Since we share the same birthday, you know my Medicare month and day!) Had that not been my thought process, I would have continued with my out-of-warranty Revel along with my Dexcom CGMS because the “right” pump decision was unclear. I have not been thrilled with the pump I chose, but given what I knew at the time, it was a reasonable decision.

I don’t think that in general pumps are a problem for Type 1’s on Medicare. You may not be able to get coverage for every pump model or brand, but most are covered. The main one that isn’t is the Omnipod. I also don’t know about the Snap since it is so new. Obviously the big problem is lack of CGM coverage, but I expect that will have changed long before 12 years are up.

And maybe you will be cured by then. But Medicare probably won’t cover the cure, so you might become un-cured at age 65.

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- StephenS On November 10, 2014 at 4:50 pm
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  Yikes! That’s a scary thought. Thanks Laddie!
  
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