The most recent study from the American Diabetes Association (ADA) reports that over 30 million people currently have diabetes in the United States and a staggering 84 million people are pre-diabetic. The study also found that, on average, healthcare costs for those with diabetes are 2.3 times higher than those without diabetes, and one in every seven dollars spent on healthcare in our country goes toward treating diabetes and related complications.
Managing diabetes for older adults can be particularly challenging, especially when it comes to the cost of treatment, supplies and medication. Many older adults are on a fixed income and thus shouldering the out-of-pocket costs associated with proper treatment of diabetes can be difficult. As medical costs mount, some patients elect to forgo their treatment, which puts them at risk for further complications.
Fortunately, there is good news for diabetic patients on Medicare. The Centers for Medicare and Medicaid Services (CMS) – the federal agency that oversees and administers the Medicare program – has made recent changes that allow health plans more flexibility to help patients with the cost of their diabetes and to better manage their condition.
St. Louis’ local Medicare plan, Essence Healthcare is one of the first in the country to take advantage of this regulation change and tackle the problem head-on. Essence Healthcare has been providing Medicare coverage to people throughout the St. Louis area for over 15 years and currently serves over 55,000 people throughout the community. Just recently, Essence Healthcare announced a new package of benefits that provides significant cost relief for those with diabetes.
This package of benefits is included in the company’s $0 premium Medicare Advantage plan and offers $0 copays for insulin, testing supplies, primary care visits, diabetic eye exams and diabetic counseling. In addition, members with diabetes in the Essence Advantage (HMO) and Essence Advantage Plus (HMO) plans receive an additional $50 allowance for approved over-the-counter items each quarter.
“We have seen the rise of diabetes in our community and were concerned about the subsequent strain it puts on older adults on fixed incomes,” said Richard Jones, CEO of Essence Healthcare. “We decided we need to tackle it head-on by removing cost barriers to proper treatment and ensuring our members get access to great primary care physicians to help them manage and treat their diabetes. We think it can really make a difference in patients’ lives.”
People with diabetes who may benefit from this plan can join during the Medicare Annual Enrollment Period which runs from October 15 through December 7. For information about the Essence Healthcare plan, visit essencehealthcare.com.