My Experience with Turning the Dreaded 26 and Switching Insurances

Sam Grover, Med School Student

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Don’t get me wrong, turning 26 was exciting. I was starting med school full time and moving to New York City - but when you have a chronic health condition, turning 26 is also the dreaded age that you get kicked off of your parents’ health insurance plan. As I prepared for this transition to new insurance, my first step was to look into insurance through my school because I know a lot of undergrad programs offer student insurance. To my dismay, my school didn’t offer student insurance and I was back to square one with finding a new insurance plan. 

My second step was to apply for Medicaid in my home state of Utah since Utah was part of the Medicaid expansion. I was THRILLED when I was approved because Medicaid covers all of my pump and pump supplies at 100%, which allowed me to even upgrade my pump to the T:Slim X2. However, there was a catch. Medicaid doesn’t currently cover Continuous Glucose Monitoring in Utah. However, CGM coverage under Medicaid varies state to state, so just because Utah doesn’t cover it doesn’t mean Medicaid in your state won’t. Thankfully, I had a bunch of Dexcom G5 sensors leftover from when I switched to the G6 a few months ago and happened to find someone who refurbishes G5 transmitters (NOTE: this practice isn’t FDA approved so please consult your medical team before looking into this!). So, I am using my leftover G5 sensors and refurbished transmitter until I run out. 

However, since I moved to New York, I will need to apply for New York Medicaid sooner than later. The pro to this is that I believe New York Medicaid covers Dexcom G5 supplies, so I may be able to have my Dexcom G5 supplies covered. The con is that I will need to give up my provider in Utah because he doesn’t accept New York Medicaid. However, I would do it to be able to have Dexcom covered again. Once I start to run out of sensors is when I will make the change to New York Medicaid. 

As for insulin, I found out I could get it through a community health center where it is already discounted and not need to involve my insurance in covering any insulin - wherever I can avoid hassling with insurance is a win for me. I get 6 vials of Novolog for around 11 dollars. I know a lot of people with stellar insurance can’t even get insulin for this cheap, so I highly recommend people look into community health centers with pharmacies to get the insulin that you’re used to at a cheaper price without switching brands or resorting to “Walmart Insulin” or NPH.

Overall, switching insurances has been a hassle but I have found ways to still get the supplies that best work for me. With a little research into the coverage and resources where you live, this giant task becomes doable and 26 isn’t as scary as it seems.

Sam Grover

Sam is originally from Utah, where he did his undergrad at BYU with a double major in Nutritional Science and Russian. He was the CDN Chapter found and leader at BYU. He is currently a 2nd year medical student at A.T. Still University - SOMA. He is currently living and studying in New York City! He loves living in NYC, loves his diabetes and loves being an advocate for diabetes awareness and education. Follow him on insta @sgeezy99.