Insurance questions? Breakthrough T1D can help

Open enrollment season is upon us, that time of year when millions of people across the country make changes to their health insurance.  For those who live with type 1 diabetes the decisions made during open enrollment will affect diabetes management and finances all year.

Having T1D makes you an expert in carb counting, insulin management and medical devices.  Knowing how your insurance plan works to cover your T1D supplies and medication is critical to type 1 diabetes management.

Breakthrough T1D provides you the tools you need to make the most informed decisions regarding your insurance coverage.  Whether you’re newly diagnosed, choosing a new policy, or experiencing a change in coverage Breakthrough T1D has the resources to help you navigate your health insurance decisions. The links below provide important insurance information for those living with T1D.

Insurance Terms

Choosing the Right Plan for you

Help with Costs

Denials and Appeals

Prior Authorizations

Switching Treatments

Insulin, CGMs, Pumps

Working with Employers

Medicare

Colorado Insulin Price Cap News

In 2019, Colorado became the first state to pass a historic bill capping the insurance co-pay price of insulin at $100 per month.   This coverage, the first of it’s kind in the nation, becomes effective on January 1, 2020.

The act caps the cost sharing a covered person is required to pay for prescription insulin drugs at $100 per 30 day supply of insulin. It also requires the state to investigate the pricing of prescription insulin drugs and submit a report of its findings to the governor, the commissioner of insurance, and the judiciary committees of the senate and house of representatives.

This new law applies to all state-regulated health insurance plans, including those currently on the Colorado Health Exchange. While other plans are not intentionally excluded, because Colorado has no jurisdiction over many group insurance plans or Medicare/Medicaid those plans are not eligible for this cap. To find out if this law applies to your insurance plan look at your insurance card. If your card has CO-DOI in the corner this law applies to you. Or, call your insurance company to find out who regulates your plan.