Financial Planning Toolkit for T1D

Managing diabetes costs, optimizing insurance, and building financial security while living with Type 1 diabetes

Understanding T1D Costs

What to Budget For

Regular Monthly Expenses

  • Insulin: $300-$1,000+ per month without insurance
  • Test Strips: $100-$400 per month (if not using CGM)
  • CGM Supplies: $300-$500 per month
  • Insulin Pump Supplies: $300-$500 per month
  • Lancets & Alcohol Wipes: $20-$50 per month
  • Glucose Tabs/Gel: $20-$40 per month

Healthcare Costs

  • Endocrinologist Visits: 3-4 times per year
  • Lab Work: A1C, lipid panel, kidney function (quarterly)
  • Annual Screenings: Eye exams, foot exams
  • Other Specialists: Dentist, primary care, etc.
  • Insurance Premiums: Monthly health insurance costs
  • Deductibles & Co-pays: Variable by plan

Average Annual Costs

Without insurance, T1D management can cost $15,000-$30,000+ per year.

With good insurance, out-of-pocket costs typically range $2,500-$7,500 per year (depending on deductible, copays, and coverage).

This is why excellent health insurance is critical for people with T1D.

Insurance Navigation & Optimization

Choosing the Right Health Insurance

Key Factors to Compare

  • Premium: Monthly cost (lower isn't always better with T1D)
  • Deductible: Amount you pay before insurance kicks in
  • Out-of-Pocket Maximum: Most you'll pay in a year
  • Prescription Coverage: Insulin and supplies formulary tier
  • Durable Medical Equipment (DME): Pump and CGM coverage
  • In-Network Providers: Endocrinologist and specialists
  • Mail-Order Pharmacy: Often saves money on 90-day supplies

Insurance Options for Young Adults

  • Parent's Plan: Can stay on until age 26 under ACA
  • Employer Coverage: Often best option—evaluate during job search
  • Marketplace (ACA): Shop healthcare.gov or state exchange
  • School Coverage: Some colleges offer student health plans
  • Medicaid: If income-eligible, often excellent coverage
  • COBRA: Temporary option after job loss (expensive but maintains coverage)

Insurance Tips & Strategies

Maximizing Benefits

  • Use FSA/HSA accounts for tax-free medical spending
  • Order 90-day supplies through mail-order for savings
  • Schedule annual appointments early in year after deductible met
  • Request generic insulin when available and appropriate
  • Prior authorization: have doctor's office start process early

Avoiding Pitfalls

  • NEVER let insurance lapse—pre-existing condition issues
  • Track your deductible and out-of-pocket spending
  • Appeal denied claims—persistence often works
  • Keep detailed records of all medical expenses
  • Understand formulary changes during annual enrollment
Prescription Assistance Programs

Help Paying for Insulin & Supplies

Insulin Manufacturer Programs

  • Eli Lilly: Lilly Cares Foundation (humalog, basaglar)
  • Novo Nordisk: Patient Assistance Program (novolog, levemir, tresiba)
  • Sanofi: Insulins Valyou Savings Program (lantus, apidra, toujeo)
  • Most offer capped co-pays ($35/month) or free insulin if uninsured and income-eligible
  • Apply directly through manufacturer websites or call patient assistance lines

Supply & Device Assistance

  • Dexcom: Patient assistance for CGM supplies
  • Abbott: FreeStyle Libre affordability programs
  • Pump Manufacturers: Financial assistance for Tandem, Omnipod, Medtronic
  • Test Strip Programs: Contour, OneTouch patient support

Non-Profit & Community Resources

  • GetInsulin.org: Emergency insulin access
  • JDRF: Resource directory for financial assistance
  • NeedyMeds: Database of patient assistance programs
  • RxAssist: Comprehensive prescription assistance database
  • Local Endocrinologists: Often have samples and program information
Budgeting & Money Management

Creating a T1D-Inclusive Budget

Sample Monthly Budget Allocations

Medical Expenses: Budget 15-20% of income (or more depending on insurance)

  • Insurance premiums: Set amount monthly
  • Prescriptions & supplies: $200-$600/month (with insurance)
  • Co-pays & deductibles: $50-$200/month average
  • Over-the-counter (glucose tabs, etc.): $30-$50/month

Emergency Fund Priority

  • Goal: 3-6 months of expenses (even more critical with T1D)
  • Cover medical supplies if lose insurance
  • Emergency insulin and supply stockpile
  • Unexpected medical costs buffer
  • Start with $1,000, build from there

Money-Saving Strategies

  • Track all T1D expenses for tax deductions
  • Use GoodRx or similar for prescription discounts
  • Buy backup supplies during insurance-covered periods
  • Utilize FSA/HSA pre-tax benefits
  • Ask for generic options when clinically appropriate

FSA & HSA Accounts: Tax-Free T1D Spending

FSA (Flexible Spending Account)

  • Set aside pre-tax dollars for medical expenses
  • "Use it or lose it" annually (some plans have grace period)
  • Contribution limit: $3,200 (2024)
  • Great for predictable yearly costs

HSA (Health Savings Account)

  • Requires high-deductible health plan
  • Funds roll over year to year
  • Can invest for long-term growth
  • Triple tax advantage (deduct, grow, withdraw tax-free)
Long-Term Financial Planning

Protecting Your Financial Future

Life Insurance with T1D

  • Reality Check: Life insurance IS available for T1D, but may be more expensive
  • Best Practices: Apply when young and well-controlled for better rates
  • Work-Based Policies: Group life insurance often doesn't require medical underwriting
  • Shop Around: Different insurers have different T1D policies
  • Improve Your Rates: Good A1C, no complications, CGM use can help
  • Consider Guaranteed Issue: More expensive but no medical questions

Disability Insurance

  • Why It Matters: Protects income if unable to work due to health
  • Employer Coverage: Take advantage if offered
  • Individual Policies: Consider if self-employed or inadequate employer coverage
  • T1D Impact: May be harder to qualify or have exclusions
  • Apply Early: Best to secure before any complications

Retirement Planning

  • Start Early: Time in market is your friend
  • Max Employer Match: Free money for retirement
  • Healthcare Costs: Plan for continued T1D expenses in retirement
  • Medicare Planning: Understand Part D prescription coverage at 65
  • Roth IRAs: Tax-free withdrawals beneficial with medical expenses
  • Work with Advisor: Find someone who understands chronic illness planning
Career & Job Decisions

Making T1D-Informed Career Choices

Evaluating Job Offers

Beyond salary, consider these factors critically important for T1D:

  • Health Insurance Quality: Often worth more than higher salary
  • Deductible & Out-of-Pocket Max: Calculate total annual costs
  • Prescription Coverage: Verify insulin and supplies are covered
  • HSA/FSA Options: Pre-tax medical spending benefits
  • Paid Time Off: Medical appointments, sick days
  • Disability Coverage: Short and long-term disability options
  • Flexible Schedule: Ability to manage medical needs

Don't Let T1D Limit Your Dreams

While insurance is important, don't choose a career solely for health benefits. With proper planning and research, you can pursue your passions while managing T1D costs. Many successful entrepreneurs, freelancers, and professionals with T1D navigate insurance through marketplaces, spouse's plans, or professional organizations.