My mom has struggled with type 2 diabetes for the last 2 decades and her current insurance has made it almost impossible for her to be medicated for it at all.
She is low income but doesn't qualify for any extra help since she has insurance, even though that insurance wont cover any GLP-1 class med
Insurance companies are the worst, and drug companies not much better, however.. you might check and see if the manufacturer of the medication that works for her has a patient assistance program that would allow her to get it more cheaply?
We looked into that. The manufacturer wont offer her a savings card because her insurance doesnt cover the drug at all and other ways I've found (Lilly Cares) unfortunately arent open for Trulicity aid applications at the moment
What drug
Might she actually be eligible for Medicaid?
the savings cards do work even if it’s not covered by insurance. I posted the Lilly one in here
All Lilly insulins are $35 a month. Can’t she use Humalog?
OP said her mom becomes suicidal and/or depressed while on insulin and her doctor is very dismissive.
Yeah, I couldn’t tell if she was saying that about Basic insulin
“The only thing they will cover is basic insulin which my mom struggles extremely with depression/suicidal thoughts when she is on for some reason…”
There are a range of medications that can help besides a GLP-1 as these other medications are intended for reducing glucose levels.
A lot of insurance companies require "hoops" to be jumped through to get to medication desired. Usually the first hoop is Metformin, which is typically cheap. Then they move to sulfonylurea drugs, then insulin. Once you go through the hoops they do cover more medications. The costs may still be high, especially the first of the year when deductibles are reset, and need to be paid again.
If there is a negative reaction to one brand of insulin, see if there is another brand covered to try and prevent the reaction. Doctors that are dismissive need to be replaced.
There is also a balance for management of diabetes between diet, exercise and medication. Fo
This!!! My insurance needed my doctor to fill out a form saying why metformin didn’t work to control my blood glucose, metformin did work but my doctor was able to write that I wasn’t able to reach my target A1C with metformin alone which is kind of a white lie but was technically true! Having a doctor that is willing to support doing this is key I find. They can’t lie, but luckily my insurance didn’t have an A1C threshold or proof of bloodwork, and accepts the prescribing doctors discretion. I did have to be on the max dose of metformin though before being able to have the doctor fill out that form for insurance.
These forms and letters are generally called “letters of medical necessity.”
It’s a bit shocking how well that can work with private insurance where I live (Alberta, Canada). My friend coworker had severe cat allergies but has always wanted to own cats and be able to comfortably visit his friends who have cats.
Insurance would not cover the special allergy shots because obviously those aren’t necessities. I suggested he get his doctor to write a letter of necessity with the root reason as he was symptomatic at work with his cat owning coworkers.
Voila. Insurance companies HATE people not working.
Hi I am sorry she is struggling. My first thought is is it possible that the current medication not covered has an equivalent brand that you could check if they have a patient plan. All the best to both of you.
What is “basic insulin”
It’s an older term for short-acting insulin. It’s far cheaper in the US, I believe, than the fancier and newer rapid-acting.
No, not with savings cards
How the American market works is always baffling to me. WTF is a savings card?
But anyway, there’s plenty of evidence of people without whatever savings cards are (or maybe they have them but costs are still super high?) who restrict their rapid acting + ultra long/peakless insulin because of your insulin costs, risking DKA. Literally there are recent studies about it..
And there’s also plenty of evidence of people who switch to short acting + long acting because of the cost but are not familiar with the increased risks and go the opposite way. Like… people have died.
🤷🏻♀️
Most of that is old.
All systems have issues. Where are you?
Yes, all systems have issues. I live in Alberta, Canada. Our issues currently stem from our government and the people who vote for them. In my province, our greatest issue is right winged shit heads wanting to suck Trump’s dick. It’s embarrassing. Yes wait times are long. Yes things are very bad right now where I live. It will take a very long road to fix the shit show our conservative government has been revelling in.
The fact that coupons are needed for people to afford life sustaining therapy is embarrassing for your whole country. The US spends significantly more money on healthcare per capita than any other wealthy nation but also has the highest amount of medical bankruptcies.
The US spends $13000 per capita and have 66% medical bankruptcies. Canada, much closer to the average, s
Coupons
People die in other countries because of different issues like waiting lists
https://secondstreet.org/2025/11/26/23746-patients-died-on-waitlists-in-past-year/
Basic insulin generally refers to N & R which are available at Walmart for around $25 a vial without a prescription. I used them for years, but it takes a lot of planning and they’re not as effective as Novolog, etc. I use Novolog & Lantus now and it’s better. Ask your pharmacist about costs, they’re much less now.
What is she on right now? Insurance should cover Metformin, which is a very common first line treatment.
She was on Trulicity before her insurance changed, she was on metphormin and ozempic for awhile previously but was pulled off of it eventually because of kidney and heart damage if I remember right. She has been on many different ones over the years but her cardiologist was originally the one that started her on Trulicty for the dual benefit
What type of insurance does she have? If it's Medicaid, typically you can choose a different carrier. Each one covers different things. Your PCP's billing office should be able to tell you which carriers, in their experience, are more likely to approve a GLP-1.
Lilly is the Drug company that makes Tirzepatide . Lilly has GLP ones , Lilly Direct is the name of their Program for GLP one sold directly to the consumer with a prescription from your doctor . , it's what I use , I am retired and can't afford much but the GlP 1 I take Tirzepatide is a prescription from the doctor and Lilly sends it to you direct it is about 250.00 per month NOT 1,000.00 the prices are going down quite a bit . I've been on this for 6 months .
Potentially just have to show you have tried other things and they didn't work, but diabetes stuff is tricky sometimes and insurance is super unreasonable often.
Prior authorization, then appeal if that doesn't work, then peer to peer if that doesn't work.
It's so awful what insurance and shitty doctors put us through. I'm so sorry your mom (and you) are dealing with this. If you would feel comfortable giving a little bit more info on where you are and what insurance she's on, either here or via message, I could help look for help. I'm on Medicaid, and I've gotten very, very good at navigating this kind of stuff. I've said, and my doctors agree, that while I don't pay money for my insurance, I pay for it in time on the phone, fighting for what I need.
If you do one thing, if it's possible to, get her to a different doctor. One that actually cares at all, they should not be dismissing suicidality like that, nor 600s! My doctor's office fights hard for us and can get most things thru insurance, but it's a lot of work on their end that your
I watched my father battle diabetes while insurers stalled. I learned anger alone fails. I wrote appeals, asked his doctor for medical necessity letters, found nonprofit advocates, and changed providers who listened. It took months but coverage came. My insight is start a paper trail today and never go alone. Ask hospitals for social workers and charity care. Persistence feels small but it saves lives.
Sounds like she definitely needs a new doctor for starters, what insulin is causes that? There are so many