#784 Bold Beginnings: Insurance

November 3, 2022Scott Benner

Bold Beginnings will answer the questions that most people have after a type 1 diabetes diagnosis.

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DISCLAIMER: This text is the output of AI based transcribing from an audio recording. Although the transcription is largely accurate, in some cases it is incomplete or inaccurate due to inaudible passages or transcription errors and should not be treated as an authoritative record. Nothing that you read here constitutes advice medical or otherwise. Always consult with a healthcare professional before making changes to a healthcare plan.

Scott Benner 0:00
Hello friends, and welcome to episode 784 of the Juicebox Podcast.

This is another episode in the bowl beginning series. And I'm so confused at this point not. It's not something good to admit to you. But I wanted this to be the last episode of Paul beginnings, but I think there's going to be some more so I'm not certain, I have to go back and look at my list and confer with Jenny and do a couple of other things. But for now, this episode of bold Beginnings is not with me and Jenny, it's with me and Sam. And Sam is here to talk to you about insurance. I know that is not exciting, but you need to understand all of the varied ways that your health insurance works is impacted how you can make it work for you. And Sam is going to walk you through a lot of it right now. While you're listening. Please remember that nothing you hear on the Juicebox Podcast should be considered advice, medical or otherwise, please Always consult a physician before making any changes to your health care plan. We're becoming bold with insulin.

This show is sponsored today by the glucagon that my daughter carries G voc hypo Penn, find out more at G Vogue glucagon.com forward slash juicebox. today's podcast is also sponsored by the N pen from Medtronic diabetes, if you're looking for some of the functionality that you get with an insulin pump, but you don't want an insulin pump, you can get that with the in pen from Medtronic. diabetes. Learn more at in pen today.com. Okay, so let's start like this. Don't say anything yet. Okay. Got it. Now you said something. Anyway, this is Sam, Sam, you won't be called Sam or Samantha.

Samantha Arceneaux 2:15
It doesn't matter. Okay, well, then

Scott Benner 2:17
I'm gonna call you, Sam. why people might be wondering, have I been listening to this bold beginning series for umpteen episodes. And Scott comes on. And then that lovely woman from Wisconsin comes on. And they talk about diabetes. And now today, it's Sam, why is that? Well, it's an interesting question. And I have a specific answer. Today we're going to talk about insurance for newly diagnosed people, some of the hurdles that they're going to run into answer some questions that people have had and sent into me. But Jenny and I were talking privately, and I said, Jenny, I think I know a person who's better for this conversation than you. Are you offended? And she said, No, not at all. And I was like, Okay, so, Sam, what episode of the podcast? Were you on? A lot? Oh,

Samantha Arceneaux 3:03
boy. Now be put on the spot. It was episode 6162. Somewhere in there. I believe it's 61.

Scott Benner 3:09
Wow. Okay, it's been a while. Oh, wow. That's the first year.

Samantha Arceneaux 3:14
Yes, it was 2016. I want to say,

Scott Benner 3:18
the second year, but but probably within 12 months of me beginning. Let's give people the tiniest bit of background actually. And give you your credit. Because yeah, yeah. So do I wonder if there's no way no one's gonna everyone's gonna know this. But me. But you're the entire reason that I'm a well received diabetes speaker.

Samantha Arceneaux 3:39
Well, that was kind of a mutual benefit. Because, you know, once you kind of hear what you have going on, it was kind of a no brainer for me to think about bringing you in as a speaker for the conference that we have down in Orlando, testify type one. So we were thrilled when you agreed to be part of our conference series. And luckily for you, I think it spread around and a lot of other people decided they wanted to do,

Scott Benner 4:07
but it was but it seriously. So you're so you're the mom of a girl with type one, right?

Samantha Arceneaux 4:12
Yes. So she's currently a lab and she was diagnosed at 22 months old. So we're rounding into our 10th year,

Scott Benner 4:19
okay. And you donate your time to touch by type one.

Samantha Arceneaux 4:24
That's correct. I'm actually a board member at this point, but I definitely do a lot of volunteer work for them as

Scott Benner 4:29
well. Wow. What's the difference between like doing the work and being a board member?

Samantha Arceneaux 4:35
It just comes with a fancy title and I have actual responsibilities.

Scott Benner 4:41
So instead of we hope Sam might do this for you, we it's we've told Sam to do this and she's gonna get it done.

Samantha Arceneaux 4:47
Yeah, so I have different chairs. I'm actually the AVID sea chair were touched by type one as well as the golf chair. We have a golf tournament now yearly, and I'm co chair for a casino fundraiser that we do.

Scott Benner 5:00
Oh, okay. Well, I appreciate it. Because you should know that while you were going to bat for me, and being like, Hey, I think we should let this guy speak at the conference. I was taking that very seriously up here. And I was very touched by it. Because it had been a it was one of those things where I kept thinking, I wonder why nobody's asking me to speak at things pretty good at this, you know, and, and it just wasn't happening. So the big the big ones weren't weren't calling. And you guys did. I had such a wonderful time. I've been I've been at every touch by type one event, have I not? Yes, you have? Well,

Samantha Arceneaux 5:38
every conference I should conference. Yeah,

Scott Benner 5:39
no. Well, please. Yeah, I'm not at the golf thing. Don't look for me there. I can't be flying to Florida every five seconds. But but every conference that and they've gotten, well, I I can't say they've gotten better, because they've been well run. And lovely from the get go. But they have gotten bigger and bigger. Yes. Yeah. Really, really beautiful. So anyway, thank you for tapping me in. And I'm glad I didn't let you down. Because I think now that we've all known me longer is probably a bad decision on your part right? Now. Anyway, so So when this idea of insurance comes up, I think I don't know anyone more capable, like in a regular just a regular person. You don't mean like more capable of answering these questions in you. You just have a knack for it. You're a savant around this for? I don't even know why I'll let you I'll give, like give everybody just a little bit of detail about why you find yourself so tuned into this. Yes. So

Samantha Arceneaux 6:42
in my previous life, as I like to call it, before I had kids, I was an office manager for a medical office that dealt with multiple forms of insurance. So, you know, we were pretty much trained on how to look at two sides of insurance and figure out where the benefit should go. So that kind of set it up perfectly for this whole pharmacy versus DME situation that everyone finds themselves in. And the other part of it was learning how to appeal properly. So once that started, and I started seeing the struggle in the community, from people who were going through the same thing, and I was experiencing it myself, you know, the whole, wait six months before you can get a pump, I really kind of jumped into this whole appeal process. And then throughout the years, just the different questions that people would come to me with, you know, it wasn't always something that was actually denied. A lot of times, it would just was them not understanding how their insurance works, or not being able to find the particular answer based on what they knew how to research for their insurance. So I would say like 50% of people coming to me for help actually didn't need an appeal, they were able to solve it through other means a lot quicker and a lot easier. So just throughout that experience, it's really become my, the way my brain works is I have a hard time for getting certain things. So it just kind of like adds on. But I will have the disclaimer and an insurance salesperson if there's something that is not true for your state. I am here in Florida. So what might be true for my state? You know, just don't don't hang me on the wall.

Scott Benner 8:23
Don't worry, nothing you hear on the Juicebox Podcast should be considered advice, medical, or otherwise, this is the other ones right here. This is the other way. But But anyway, I would believe that anything you're going to say would at least be a good breadcrumb to get started. So is exactly is it accurate to say that none of us none of us understand our insurance that well, because it's it's set up so that we have a hard time understanding it.

Samantha Arceneaux 8:50
It is definitely one of those things where they pretend they give you a lot of information without giving you information. They are going to be obviously covering a wider amount of items, you know, there, there's a ton of other health conditions out there a ton of other medicines out there. So they kind of give you like the here, here's exactly what we'll pay for. But there's all of these policy guidelines and stipulations, and that's going to be buried on a website that's really hard to get to but you think you've got the coverage for it. So yeah, they're they kind of like hide the fine print and especially with open enrollment, when it's a little bit even harder to get into all of those documents that you might need. It becomes really frustrating sometimes, but, you know, I think the best that we can do is, you know, do as much research as we can find and, you know, kind of make your assessment there. And

Scott Benner 9:53
you know if it's, I'm sorry, yeah, I didn't think I is it sometimes just the is that the word asking the wrong questions. I used to man i for a minute. I hate to throw up my little brother right under the bus, but my youngest brother was quite the schemer. And one year, Sam, my mom bought a Carvel ice cream cake from my other brother's birthday. And in the center of it was a picture of a hockey player. And we came home one day, at my house, the rule is, you get a birthday cake. Everybody has some, and then whatever's left is yours. And you can eat it as you want, give it away, whatever, but it's yours to deal with. So my brother comes home one day to have a piece of his birthday cake. And the hockey player is hacked out of the center of the cake. In artfully man I say, and my brothers, of course, like, Hey, what the hell happened? So he turns to me, he's like, did you eat my my cake? And I said, it wasn't me. I'm sorry. So he goes to my younger brother, our younger brother. And he says, Did you eat my cake? And my brother says no. And that was it. So my brother asks, and he looks at me, are you sure and I'm older and sort of like, I'm almost there Dad, to be perfectly honest. He was no like, 15 at the time. And so he doesn't just trust me. He turns back to rob, and he goes, come on, man. Did you eat my cake? And my brother goes, No. And this goes on for quite some time. And finally I went way, way, way, way. Wait. And I go, Rob, do you know who ate the cake? And he goes, Oh, yeah. So my brother asked, Did you eat the cake? And my brother on my other brother honestly answered? No. And sometimes I think that's what this insurance game is. It's like asking the right question, you gotta ask the right question because it feels like they gave you a puzzle and said, if you put this puzzle together, you get an insulin pump. And then they take three pieces of the puzzle and stick it in their pocket. And then they go I don't listen, Fair's fair, you can have the pump just put the puzzle together. And so how do you but that's incredibly frustrating. Because unlike my brother in the in the ice cream cake. I don't know all the I don't know all the pieces. Do you know what I mean? Like, I know they exist, but I don't know where they are. And you have this, this kind of, you know, intuitive knowledge because of what you've been doing for so long. But how are you? Not? Let's answer, let's ask some of the people's questions. And we'll see how this goes. Okay. So everybody knows bold Beginnings is a series of input from the listeners when I said, What do you wish you would have known when you were first diagnosed? And this is what we got for insurance? Do you listen to this series by any chance, and

Samantha Arceneaux 12:41
I don't tend to lean towards the ball beginning just because we've been going for so long.

Scott Benner 12:47
This is going to be a surprise for you how this goes perfect. So the first person just makes a statement. Navigating insurance is huge that we know.

Samantha Arceneaux 12:54
That's a whole that's you got a couple hours for me on that

Scott Benner 12:57
one. The whole thing, right? It's just, it becomes a really well, in the beginning, it feels like it's a very big part of your life.

Samantha Arceneaux 13:06
It is absolutely because that's usually the panic sets in of oh my gosh, you know, I'm newly diagnosed, or I have a child who's newly diagnosed. And then the second thing is always how are we going to afford this? So it's, you know, with With luck, they have insurance at the time that they were diagnosed. But if they don't, then you know, it's generally they're going to quickly get it or try to find better insurance.

Scott Benner 13:30
So the first question here is how do you navigate insurance to find the best coverage for insulin and supplies? So we'll start with that. Let's put ourselves in, in open enrollment, or we just got a new job. And they're like, here are three insurance options. What are you looking for?

Samantha Arceneaux 13:45
So generally with insulin and supply so the first thing I kind of like forewarn people with insulin is that people get very brand specific very quickly. You know, it's kind of a built in loyalty because that's what their doctors prescribing. But generally, you want to look at what's on the formulary. The formulary is kind of like your your go to and most people can use different insolence that are on the formulary versus what the doctor originally prescribed without complications. You know, some people have better reactions to certain insulins, or they might be allergic to one of the stabilizers in the insolence and that would be a necessitating reason to go to something off formulary. But for most people, you know, they're looking for insulin coverage in general, a long acting and short acting or a short acting. Same with supplies, you know, it's pretty, most most insurance companies are going to cover something. It's usually a law in their state that requires a base amount of coverage. Most states have that law, that insurances are required to cover certain things. They just don't specify what brand. So as far as best coverage, it really comes down to them. What's the Cost of things. And that's really where finding the formulary with the insurance that you're looking at is key because even though, you know, I was talking about how open enrollment can kind of take things and make it a little bit harder, because you don't have that as much access, generally, unless it's, you know, a self insured plan, which is where a large company basically pays for their own policy to be managed by an outside company, but at the end of the day, they're paying all of the, the costs of, of the patient's medications and their, you know, surgeries and everything. Unless it's a self insured plan. Most of the time, you can find those formularies either the current one so you get an idea of what they're covering, or, depending on what time of year it is, they'll release the 20 for us or in 2022. So you'll start seeing the 2023 formularies come out.

Scott Benner 15:52
Okay, so Sam, do me a favor trying to touch that microphone on the cable. Okay, if your hair is brushing it, move it away. Okay, so, first step, we ask, can I see the formulary so I can see if the things excuse me, so I can see if the things that I need are on there. Exactly. But if I'm newly diagnosed, I don't know what the things are that I need. So this is a great time to say for people you're looking for. Like Sam said, insulin first, long acting short acting insulin, more modern insulins like recibo over Lantus, for example for your basil, you're also looking to see does the plan cover insulin pumps, continuous glucose monitors, test strips, those sorts of things are those

Samantha Arceneaux 16:40
XCOM libre those things on the formulary are really big indicator of how later you'll proceed and getting those covered so when you're looking at your formulary does it lists the Dexcom G six or you know in the future the G seven doesn't list the libre two or the libre three. If you're seeing those items on the formulary before you even sign up for the plan, that's a good indicator that you will be able to get that through the pharmacy channel rather than having to go to the DMV.

Scott Benner 17:13
When you have diabetes and use insulin, low blood sugar can happen when you don't expect it. G voc hypo pan is a ready to use glucagon option that can treat very low blood sugar in adults and kids with diabetes ages two and above. Find out more go to G voc glucagon.com forward slash juicebox G voc shouldn't be used in patients with pheochromocytoma or insulinoma visit G voc glucagon.com/risk. I'm going to share just a bit of a note that I got from somebody with you. This person says this podcast gave me my life back and told me about in pen, my insurance covered it 100%. And it's amazing. Just the insulin on board feature alone is a game changer. But I'm going to tell you a little more about what in pen does so in pen is an insulin pen that pairs up with an app on your phone. This app shows you a dosing calculator active insulin remaining glucose history reports activity logs, dose history meal history and your current glucose level. This person I was just talking about ended up getting it for free through their insurance. But even if your insurance doesn't cover it, it's possible that in pen will cost you as low as $35. That's because Medtronic diabetes doesn't want costs to be a roadblock to you getting the therapy you need. So with the implant access program, you could pay as little as $35 offers available to people with commercial insurance terms and conditions apply. You'll learn more at in Penn today.com. While you're there, you also see pictures of the pen. See the app, you can learn about the 24 hour technical support, they offer hands on product training, and online educational resources. The in pen is a great way to get some of the functionality that you're missing by not having an insulin pump. So if you're MDI and you're using a pen, you might as well use the pen pen because it does all this check it out at Hidden pen today.com in pen requires a prescription and settings from your healthcare provider. You must use proper settings and follow the instructions as directed where you could experience high or low glucose levels. For more safety information. Once again you can visit in Penn today.com I'm going to get you back to Sam Now here we're going to use more words like durable medical and other fun things like that about insurance. I know this is boring, but you'd need to know this and Sam is delightful, so that helps Durable Medical Equipment DME and a lot of the stuff now people you know old timey people like you and I know that like insulin pumps and continuous glucose monitors used to be strictly durable medical equipment. And now, I guess you I get on the pod through a pharmacy channel, I get Dexcom through a pharmacy channel to die.

Samantha Arceneaux 20:09
Yes, yeah. So definitely Omni pod is generally this day and age going to be through pharmacy, that's how they've decided to set up their distribution. There's the old style Omni pod, of course through DME, but the newer stuff is definitely through pharmacy, for the most part. Dexcom is about 5050 at this point on whether it's going to go through DME or pharmacy, and sometimes you have the option of either choice, you know, and that's really important as far as cost savings, because if you've been doing DME, and you're subject to a deductible, and you're paying, you know, hundreds of dollars out of pocket to get this product that's going towards your deductible, if it's added to your formulary, and I will, I will preface this formularies can change throughout the year. So things can get added and taken off during a year. So you, you know, I hate to discourage somebody but it's also a pro that when new things are added, you get that access to them. So if something suddenly becomes $40 copay, you're going to be saving a lot of money by switching the pharmacy side.

Scott Benner 21:15
Okay, so But back to the initial idea of I'm trying to choose an insurance. So I call the just the 888 number on the back of my card and I say I need the formulary. I'm thinking I'm picking through but I guess if you haven't chosen yet, and you're stuck with,

Samantha Arceneaux 21:30
like I said, generally online is going to be your friend. What what a lot of times I'll do is I'll type in the insurance and always put the state because it does vary by state. So I'll say for instance, Aetna, Florida policy guideline, and then I'll put CGM or insulin pump. So if I want to know what are the restrictions on getting an insulin pump, or a CGM, before I choose that, that will pop it up. Or I'll say, you know, Aetna formulary, Florida, Open Access Point of Service, and that will pop up at least this year, so I have an understanding of what they're covering currently.

Scott Benner 22:08
So this is a situation that is seriously it's on you, right, like, no one's gonna come help you with

Samantha Arceneaux 22:14
it is, you know, you, if you've got a really great HR, you know, or a really great insurance broker, then, you know, they can kind of do some of this field work for you. But, you know, keep in mind during open enrollment, you and everybody else attached to them is probably asking, you know, a million questions. So even then, you know, it's not always, you know, the most thorough thing or the most timely for whenever you're trying to make your decision. So, you know, really online, they've, they've produced a lot of information online, you just have to know how to get to it. Okay,

Scott Benner 22:48
all right. So do you have, it sucks, because, think back, you, when your daughter was diagnosed, you've worked in that office,

Samantha Arceneaux 22:58
I had actually just left about a year and a half prior

Scott Benner 23:02
to that. So you still had the knowledge but I'm trying to put myself in the position of somebody who's like, I work in a ball bearing factory and now I get this diabetes and I have to go do this thing. Like you know, I mean, people with diabetes are lucky that you that you that you share your knowledge because it's it's not it's a it's a specific thing that you had this information in your head already when you when you came to need it. Okay, so So we're looking for coverage for things that you think you might need. We're looking for, I mean, I imagined to you have to see about your deductibles your out of pocket to see how much you're gonna have to pay in cash every year before you even get to your insurance.

Samantha Arceneaux 23:39
Yes, and let's let's take a moment to kind of explain that because that is a question that comes up a lot is, you know, what is? What is the deductible? What is a coinsurance? What is, you know, the out of pocket? And how does this apply to our situation? So what you'll always look at is, when you're looking at the different policies, it'll it'll explain, is this a copay? Or is this subject to a deductible. So if it is, such as a deductible, say it's $3,000. That means for anything in that category, such as inpatient, outpatient, sometimes it's DME, you will be paying the first $3,000 of those costs. So that is before any other portion of your insurance kicks in. And then after that, if there's a coinsurance listed, say, 30% 20%, whatever that is, then whatever that charge is, after the $3,000, say, you know, you're up for your next order, or, you know, you're getting an insulin pump, and it's $5,000, you're paying your first 3000 And there's $2,000 left and it's a 20% coinsurance, then you're saying $22,000 times 20%, you know, that's an another $400 added to the first 3000. So you would owe $3,400 For that insulin pump. But after that for the rest of the year, you're only paying 20% of those supplies until you hit your out of pocket Max. So out of pocket Max is kind of like the all in cost, and not including the premiums, but the all in cost of your out of pocket expenses on using your health insurance.

Scott Benner 25:10
Oh, yeah, I've just jumped out a window, Sam. Good luck, everybody, I gotta go.

Samantha Arceneaux 25:18
I know, I'm like, Oh, it gets granular talking about it. But you know, it's important to understand what those things are. Because it does get complicated, you know, what is coinsurance versus a copay versus all of these different things, especially when you're trying to calculate so, you know, kind of going back into, it's not necessarily navigating through insurance to find the best coverage, but it lends to finding the best monetary value. And I always say, do a spreadsheet. So, you know, if you've got like three or four plans that you're trying to narrow it down, I look at okay, what is, what are those copays? What are those expenses? And if I were to go in the hospital this year, versus having a typical year without a hospitalization? You know, what's kind of like my worst case scenario? And how much does that premium cost versus a premium for, you know, just your regular maintenance year? With nothing happening? And what is your risk factor? What are you willing to risk, in order to have, you know, more money in your pocket on a monthly occasion, but but per chance, you know, risking that if you were to be hospitalized, it has a larger deductible. So, you know, some of this is very individual, and what you're willing to risk, as far as saving money and finding that insurance. You know, if you're not sure, you know, how your hospital risk is, in the first year, because you're just diagnosed and you're still getting handled, you know, you might want to go a less risk, you know, maybe a little bit more expensive plan that doesn't have as high of a deductible or no deductible. But then as you kind of get a grasp of how your child or yourself is reacting with all of these variables, you know, how did they react with, you know, sickness, or, you know, they broke their leg or whatever, you know, if they're very rough and tumble child, and you know, you're always in the ER, you don't want something with a high deductible plan. You know, because there's other things besides just diabetes

Scott Benner 27:17
recourse that is there. I I know, it

Samantha Arceneaux 27:21
kind of seems like, you know, this is all over focus, but

Scott Benner 27:23
I don't know about the rest of you. But I always enjoy the phone call in February, where you're ordering something. And the person says, Well, if you've met your deductible, and I go, Oh, please, met my deductible on January 1. But thank you very much. I appreciate appreciate your concern about whether or not I've met my deductible. Right? Here's the question. When insurance is being difficult, this person says, skip the bullcrap of calling them and jump right to human resources, Department of Work, if you have one at work, it has saved me time and also gotten me answers that I wanted. Because the poor person on the other end of the phone at the insurance company is just doing what they're told and reading out of a manual. So do you find that every HR department knows what they're talking about? And will be helped? I would

Samantha Arceneaux 28:06
say, No, we've definitely say, there's definitely been a lot of feedback across the board, that various companies and various sized companies that certain hrs are a lot more dependable than others. You know, it, you're relying on an HR person to actually know what they're talking about with their insurance. And, you know, if you have somebody who isn't as enthusiastic about finding those answers, or really understand anything about diabetes, to, you know, if they're getting pushback from the insurance company to really go into it, and, you know, hammer down those fine details, they might just be coming back with the same answers that you're getting. So, you know, the quality definitely varies, but it's not to say that it's a waste of time, because you won't know until you try Of course.

Scott Benner 28:53
Yeah. So maybe you'll get lucky. And you'll have a great HR department, like the person who sent in this, this idea, and maybe you'll walk in there and find people who are just as confused as you are. So

Samantha Arceneaux 29:02
yes, and of course, you know, HR is another thing, you know, if you're finding restrictions, sometimes if it's, especially if it's a self funded plan, the HR person can be really key and getting an override on those because if the, if it's the the employer is the one deciding those things, what's covered and what's not, you know, they're the ultimate decision maker. So going to HR is alerting them that this plan isn't working for all the members and getting them to do those overrides, it's really key. But if it's a plan, that's kind of a generalized plan that you know, like a Marketplace plan or something that is not self funded, then you're kind of a little bit more restricted in what HR can do for you.

Scott Benner 29:42
Okay. All right. I will tell you just the quickest story I think I've told you here before but it fits here. When Arden was really little. She had a bunch of cavities on her baby teeth. And I'm gonna guess they were probably from juice or something like that from having diabetes and the A doctor, you know who we took her to, to fix them. He said, Look, she's got to be out for this. And this was before Dexcom. This was you know, before, I don't even think garden had a pump back then. And he was like, I'm not putting this kid asleep in my office and have a you stand next door testing or blood sugar the whole time, like it all, it just doesn't seem like something I want to be involved in. I want to do this in a hospital setting where we can have her we can put her out there be an anesthesiologist, and somebody can track her blood sugar kind of in real time. And we'll have her hooked up the dextrose this whole thing we're like, okay, like, I mean, we don't know, you know, Sam, like, whatever. So we, we find out that's gonna cost like $15,000. I was gonna say it's, it's a lot. And my wife's like, we'll just pay it. I'm like, Who is we? And where do you think we're getting $15,000? From? Like, I was like, wait, what, like, you know, so I really just kind of kept pouring into it. And then one day, I realized, I don't remember how I figured it out. But something you mentioned earlier, my wife worked for a big company. And so I contacted them. I explained the whole situation. And they said, Oh, we're, we're self insured. And I was like, What? What, you know, explain that? Yeah, explain that to me more. So let me let me tell you what, I think self insured means salmon if you tell me if I'm wrong, but basically, these really big companies use health insurance companies to facilitate the insurance. And then once a year, or once every six months, or how often they've agreed to it, they just write a big check to the insurance company to pay for what that has been covered. So they sit down in the beginning, and they create a formula they see here are the things we'll cover. And here are the things we won't cover. And if you need something that's on the will cover it list, then your insurance company says yes to it, you get to go do it. And then every few months, your company writes a big check to cover that for you and all of your other, you know, all the other people that work there. Is that about what self insuring means?

Samantha Arceneaux 31:59
Is Exactly Okay. And you nailed that. Weiss

Scott Benner 32:03
company just went, oh, we'll pay for that. Perfect. That was it. And then they call the insurance company and said, Hey, say OK to that, and then it was over?

Samantha Arceneaux 32:15
It was that's what I mean about quality. Ah, don't discount either. Everybody is gonna do that.

Scott Benner 32:22
Yeah. Also, don't discount the talking to me on the phone. It's not a big bunch of fun, Sam, just so you know.

Samantha Arceneaux 32:28
I was I can only imagine it probably about like talking for them to talk to me. I've definitely had my share of heated conversations. Companies.

Scott Benner 32:36
Yeah, I, you know, I believe this out, but back in the day, I was not above yelling during a phone call with an insurance company.

Samantha Arceneaux 32:45
Well, you know, kind of a not a little warning. But you know, one thing that I do find frustrating is, you know, you've got also things like clearing houses or you know, those facilitators, for instance. So for instance, for us, we have a company called the care Centrex, who runs all of our DME through Florida Blue, which Blue Cross Blue Shield of Florida. And when I get on the phone, they're insisting that our DME is subject to the deductible. Well, the plan that we have on Florida Blue, is a $0, copay, coinsurance deductible. It's like the one excluded category that isn't applicable to deductible, which is why I love this plan. We've been on it for five years straight, I am very intimately familiar with how this plan works. And she was yelling at me telling me this will be subject to the deduction, deductible, and I just got so frustrated, because how many other people would hear this, and be on a new plan like this, and just take her word for it that oh, my gosh, I'm gonna have to come out of pocket 1000s of dollars for this product. Now, when I thought my plan covered it, but this lady is telling me, so you know, if you're in a disagreement with somebody, and they're giving you this information that just does not jive with what you thought the plan was doing, go back to your broker and have the broker take a look at it and explain everything. Because ultimately, you know, they're going to be the one who knows how to read that insurance plan the best versus like you said, there's somebody on the other line with a manual, three, three ring binder, or, you know, they're staring at a screen and they don't necessarily understand how that applies specifically to the product that you're requesting.

Scott Benner 34:23
Yeah. Well, you first of all, you're going to be surprised a lot during this process, how the person you're talking to, you're gonna think they understand what you're talking about. And they don't like be even like the difference between a transmitter and a sensor for like, Dexcom G six as an example. They're like, they're like, Oh, we see we already sent you six of those. You only you're not supposed to get them. I'm like, No, those are the sensors. We are supposed to get them. I wouldn't get six transmitters transmitter Oh, and they go back and they're looking at codes. They don't even know. They don't know what an insulin pump is. They don't know why you need it. You can explain to them all you want how dire it is and everything. They're just people doing a job. They don't, they don't know. I think your, your best bet is to learn how to very politely say, I appreciate everything you've done for me. I don't think we're going to come to a resolution. I'd like to speak with your supervisor, please.

Samantha Arceneaux 35:15
Yeah, yeah. So be afraid to ask for a supervisor because they're generally, you know, different levels. And, you know, they might accidentally Disconnect the call, you know, that's happened to me a couple of times, suddenly, the call drops, miraculously. But, you know, don't be afraid to call back. I know that, you know, it is not the funnest thing in the world. But, you know, you've got to remember, you're the advocate for yourself, where you're your child, and, you know, it's just, I wish I had a magic answer that, you know, got around all of this. When we were, we were, but

Scott Benner 35:56
there's no magic answer. The answer is persevere. Yeah, keep your head, be well informed. Understand that what you're asking for, especially if it's covered is reasonable. And that you, there is a person who will answer in the affirmative, you have to get to them.

Samantha Arceneaux 36:13
And I would also say just remember that everything is recorded. So you know, you don't want to give too much information of kind of the the sob story part of it, where it seems like you just want this as a, I would say, there's a term I'm looking for convenience device. So a lot of times insurance companies will put those in their notes that this person is just looking for a pump upgrade, or they're looking for just something that makes it seem like you are just asking for it, because it's fancy, or it's nice. And really, that's not true for most of us, but they'll use that for a little bit. And you have to appeal it and just becomes a process. So, you know, just kind of I always tell people stick with the medical reasons. Because if it is recorded, they can sometimes take those things and hold it against you.

Scott Benner 37:06
Oh, so yeah, they're swatting flies, they they know you're eventually going to land on the countertop and make everything dirty, filthy. But they're just going to swing and swing and swing and swing as long as they can to keep you from getting what you want. So they don't have to pay for it. It's it's such a sad thing to think. But it's cheaper to pay a person to sit on the phone and bat you away than it is to pay for your insulin pump. And then the irony is, is once they pay for it, it's all good. It's never a problem again, it's just always like except, you know, at the end of the year when, when it's time to, you know, why does that happen? This this question is not on here. Sam, I'm gonna ask a question. Why is my daughter been using on the pod for a bazillion years, and every year when the calendar flips over? We all act like we don't know what we're talking about.

Samantha Arceneaux 37:57
I think that's true. A because you never know what your insurance is going to do. You know, there's no and I say this, to save people money as well, you always want to look every single year at what your plan has changes for including the formulary, especially as Omni pod is moving to formulary, those Dexcom every year those can change. So you know, it's it's okay to have like a little bit of weird, weary, kind of, let me see what this is doing phase because it is potentially something that would cost you money, if you're not on top of it, and things were to change and you didn't pay attention and select something that was better for your situation, while it was still open enrollment. Because once that open enrollment closes, you're kind of you're better at all the curse words on here, but you know, your, your skirt. You know, you're you're waiting for a special reason to get off of that plan. And onto a different plan at that point. And so, you know, it's really important during open enrollment, which it is right now, you know, with this November 1, some states have open enrollment, it's starting early, or companies have it starting early to really like analyze all this stuff and realize this is my plan for the next year. This is my deductible for next year. If this is my deductible, and I end up in the hospital, am I putting away money every year for those reserves to be able to afford this? So, you know, I know you're saying every year you kind of like forget that you're on Omni pod and stuff, but it kind of is you know, like starting a brand new year.

Scott Benner 39:38
It's one of the most adult things that I do is that conversation where my wife and I sit down and decide if we're on the right insurance plan for the next year. How much do we want to how much deductible do we want to have that health care spending account, which I hate? I hate it because I always forget to you said, and then pre tax dollars. God, Sam, do you think people know so if your company offers you a health care spending account, you may be able to pick an amount 1000 2000 $3,000 A year and have your money diverted into this account. So that when you buy things at the pharmacy, for example, that are covered, you can pay for them with pre tax money, money that has not been taxed yet, which is lovely. I mean, I don't know what it really saves you in the grand scheme of things. I mean, if you did $2,000, and your tax rate was at 25%, I guess it saved you 25% or $2,000, which is great, you know, but for me, I go to the damn store, I pick up the thing, I hand them the card, I paid for it. And then I think five seconds later, God damn it, I didn't use the healthcare spending. But now the pharmacies at least brick and mortar pharmacies, even online, I guess, it is easier because you can give them the card and say put this on file and pay for my stuff with this. Yeah, so that has

Samantha Arceneaux 41:02
to save the receipt as well. And you can try to go back to them and say, you know, this was a qualified expenditure, yes. And see if you can get that applied as well,

Scott Benner 41:11
Sam, now you're getting a look into my psyche, because I really didn't want to do. And also, we get into an interesting thing where I kind of have to handle the bills at my house, but the insurance comes through my wife. So when we got into a situation like that, I was suddenly dragging her into something she didn't really get involved in very much. So I'm like, hey, I need you to figure out how to like submit this. And you don't I mean, what's your online access for your health insurance portal? She's like, I'll take care of it. I don't want you to know my codes. And I was like, No, I understand. I'll trust you either. Now, just kidding. But no, but she would turn into like she she would then get involved, it was frustrating for her, what we learned to do, because I kept forgetting to use it $25 here and $20 here and everything is we would just wait for like one big expense, you know, just a dental cost or something like that. And then we would submit that cost to the health care spending to take the money out and kind of one big chunk. That makes sense or not.

Samantha Arceneaux 42:09
Everybody does it differently.

Scott Benner 42:12
I just I every year I say to my wife, like don't put money in that she's like, it saves us money. I'm like, I hate it. So, but it is a great idea. Honestly, it's just it. Again, it's something that seems to me. Like it's it can be made to be more difficult than necessary. And I think that really is why this part of it sucks so much. It's the intersection of health and sanity and money. And you just like why do I have to deal with this? Like why? Like, the kid already has diabetes, I already have diabetes, I gotta jump through these hoops now to get medication to get to get a device like it sucks. And you know, it's reflected here. And what people said, this, this person says navigating insurance could honestly be a whole podcast by itself. With that, but that was like, she doesn't just mean an episode of this podcast. She means a there could be a podcast somewhere that just talks about this with nothing else. She said it was so confusing to me at first. Everyone's insurance is different. We've had four different insurances in the four and a half years since my son was diagnosed, I still double and triple check, calling insurance, make sure you understand what's covered and how much I didn't even have any idea what DME was, and how it was processed differently than prescriptions. I thought it was ridiculous. This person says that we had to wait a month before getting a Dexcom. But then another person says to Hey, let people know, insurance won't pay for a CGM until somebody sees the endocrinologist. And I was like, Oh, that's interesting. And but that could be specific to their state as well. Right?

Samantha Arceneaux 43:46
Yeah, I'm not sure exactly what they're alluding to. I mean, obviously, you do need a prescription for that item. And most of the time it is going to be the Endo. But you know, there's definitely plenty of family practitioners, you know, especially in the type two side who are able to prescribe that and insurance will cover it. So I'm not entirely sure what their meaning by that but I'm sorry. Okay, so, diagnosis might be the key. Maybe their insurance was saying, you know, you haven't had the seed peptide testing or whatever it is. But a lot of those restrictions I've kind of modified in recent years. So hopefully, whatever that person was dealing with it with their insurance, as you know, had some policy changes that may get a little easier access.

Scott Benner 44:30
That's very worth mentioning too, is that this process has, I mean, Arden's had diabetes, and she was to choose 18 This process has gotten better every year incrementally. Yes, you know, like,

Samantha Arceneaux 44:45
yours. Even just, you know, the last time I was on was, you know, kids under seven couldn't get a CGM without a fight so you know, that's definitely come a long way because you know, studies evolve and, you know, the manufacturers go after younger and younger target. It's to try to make sure that they're not having to go off label and you know, have those battles for those patients. So it's definitely come a long way. Obviously, it's not perfect because insurances don't want to pay if they don't have to. But

Scott Benner 45:13
yeah, this person said it was really difficult, because we wanted a pump and a CGM. But we had to wait because insurance made us wait.

Samantha Arceneaux 45:22
Yeah, so on that, so the Dexcom. For the first month, generally, what they're saying is, there's like a 30 day log, some insurances will want of blood sugars. Those, you know, if that's going on, I would just ask the doctor to advocate for, especially if it's a younger patient, who, you know, just does not understand that they have diabetes and what alo is and how to feel that and tell an adult, you know, there's definitely a lot of kids who leave the hospitals with CGM. Some doctors are very much alike. No, this is what the insurance says that's what we're going to abide by. So, you know, sometimes it's not even the insurance company necessarily blocking it. Sometimes it's also the doctors who aren't as gung ho about, you know, kind of getting somebody on index calm that quickly, because they want to make sure that somebody knows how to properly check their blood, or that they understand what the lows are feeling. Or they want you to go MDI for a while, in order to, you know, if your pump were to break down, know how to treat yourself, and they want you to go ahead and wait six months. So if it's a six month waiting period on a pump, that's a common one. And that's definitely something that is completely appealable, especially with younger children, it's, it's kind of a no brainer, you know, for for a young child to be on a pump and my, my opinion, because there's the users who are grazing their snacking, you know, you want to have that control over it. And your choices basically become no insulin, point five, one point out, you don't have those little tweaks or for that blood volume, like there are so you know, when you lay that out for an insurance company, you're talking about blood volume, and you know, the carbohydrates, and you know, how, how fast it spikes the blood or how quickly it impacts the blood sugar. Having those micro doses, it really kind of becomes a scientific equation for those insurance companies to say, Okay, why aren't we covering this? Because this is difficult for this user. So it, like I said, it goes back to what is the medical nature? And how do I get that past big insurance company to make it a no brainer for them, or to make it something where there's something called Bad Faith and insurance as well. So they have to, in good faith be given coverage for these things. And if they're denying things just to deny them, and there's no reason to deny them, then they're in bad faith, and they actually could be subject to problems with the State's Attorney General. So you know, they've got to kind of go for that line of fiscal responsibility versus not getting in trouble with your attorney general.

Scott Benner 48:06
Interesting. Well, let me read what this person here said. Please, first, they said they were insurance like long like them, just because a doctor prescribes something. Please don't think that that means that it's preferred item on your formulary. And that a lot of times high pharmacy costs are from the wrong item being filled versus what you could have saved on. You talked. You talked about this earlier. You didn't say it that way, though. You know, your prescription is written for human blog. But it's not covered by your insurance. So no vlog would have been cheaper, but you're like, No, I want Humalog you might get or

Samantha Arceneaux 48:45
my doctor prescribe this, this is what I need.

Scott Benner 48:48
And that's tough. Because in the very beginning, you have no way of knowing, like, that's the other thing we're not talking about here is it the people listening to this are going to be newer diagnosed and are going to know what they're doing. And they're going to really think that like, I don't know, the guy said, Novolog like, now you're trying to give me a pager, which I don't think would happen because nobody covers a pager, but you know, vice versa. And so, it's um, it really is. There's a there's a settling in period. And you do need experience with this, just like with diabetes, you will actually get better at this. You'll notice that there, you'll look back one day and think, Oh, I was beating my head against that wall for absolutely no reason whatsoever.

Samantha Arceneaux 49:26
And yeah, and and the other thing, too, is just, you know, for those who are newly diagnosed, just realize there are a lot of programs out there, especially insurance, or sorry, insulin based ones for copay cards, and a lot of people just, you know, kind of forget that they're available or they don't realize that it applies to their insulin, or they think that Oh, I make too much money. I'm not going to qualify for those, but they really have had kind of a kick in the butt recently with all of the investigations with the Senate committees in order to facilitate more Portable insulin. So you know, you've got the NoVo notice you've got the lily drug cards, there's, you know, the NoVo care, there's a $99 Insulin program, Lily has a $35 a month insulin value program. Sanofi also just recently came out with a $35 a month insulin program. So, you know, investigate those, especially if you're struggling to afford your insulin because obviously, that's a life saving medication that you absolutely need. And, you know, there's also a 340 b program, and I hate to bring it out, because it's government. And it's very political in nature. So sometimes it does better at helping that others. But if you are somebody who has an insurance, if you can't afford to even really see the doctor, there's community health centers that are on a sliding scale, and you can get a prescription from them and go fill your prescription out of 340, the pharmacy, and they will take into account how much you can afford. And you know, it can be relatively cheap. However, I will say depending on how many vials you need, it may or may not be cheaper than say one of these drug copay cards, but at least the Community Health Center doctor, you know, should have been less expensive than going to see an endo you know, your regular Endo, you know, as a self pay patient per $100. So,

Scott Benner 51:24
I just Googled 340 V pharmacy and I didn't know anything about that. That's interesting.

Samantha Arceneaux 51:29
Yes, it's kind of it's not just for insulin, it's for you know, a lot of different medications are included. It's just the insulin manufacturers. By doing these copay cards have kind of been pushing back a little bit. And that's why I say I hesitate to just say, Hey, this is a solution for everybody. Because, you know, sometimes they don't want to necessarily give those discounts out. And it's different per state. There's a lot of hidden information on exactly what the costs are for the pharmacy products. But you know, if you are just in need, definitely look at that for your state.

Scott Benner 52:07
You also Walmart was on here last year, because they're selling Novolog. It's kind of its rebranded. It's just it's called it's called rely on Nova log, but it's just trust me, I went through the whole thing, it's Novolog. So the problem is that talking about it brings up memories for people of older, outdated insulins that that are available at Walmart as well. And sometimes people think you're, you're talking about that, but I'm not talking about that I'm talking about Novo LOGG is available at Walmart, as long as you know, I

Samantha Arceneaux 52:42
have Have you seen the recent pricing on the Nova log at Walmart. And the reason I bring this up is it's not always the best deal because of these copay cards. So say, you know, it's $80 to go get a vial of this generic Nova log at Walmart through the rely on and the, you know, you need two vials for that month. Well, the NoVo program is $99 for up to three vials. So you know, I mean, you're getting that second vial for $19 rather than $80. So

Scott Benner 53:12
we'd really want to look at the company's code. Yeah,

Samantha Arceneaux 53:17
just do do do the math. You know, I always say like, what is your time worth? You know, when you're doing these spreadsheets to look up different plans, and, you know, the insulin costs, the affordability resources that are out there? You know, is it worth, you know, a couple of hours out of your year to figure this out and save hundreds or 1000s of dollars? You know, for me, I'm, I feel like I'm worth it. I'm way cheaper than that.

Scott Benner 53:44
I would do things you have no idea for like 50 bucks. Yeah, no, I, you know, when it goes to this last comment I have from this person here is test as much as all this sucks, anticipate that expenses are coming. My budget totally changed. And I spend a lot more on medical costs now, even though I have insurance. And I think that's just important to remember that. I mean, I can't tell you, I don't know what your insurance plan is or what it covers or anything. But I mean, I think I said it recently on here to cover a family of four. So the amount of money that comes out of my wife's check every month to cover a family of four plus the amount of money that we spend on diabetes supplies and co pays and things like that. I mean, I guess earlier, we might spend $7,000 a year maybe, like you don't think of it that way because most of it comes out of your check. You just don't see it that way. But it's the truth. You know about that much of our income goes to covering this every year seven $8,000 And that's if nobody gets sick. Yeah, yeah,

Samantha Arceneaux 54:47
that's what I'm bringing up Sunday when you when you talk about this and this is really important for those people who are especially just starting out on this insurance journey is when I say look at different things on Have insurances every single year. I also mean, look, if you're on an HR plan, you know, you've got a company health insurance plan and say your child has type one diabetes, it's okay to split off that child onto a different plan that say, on the marketplace or off marketplace that's not on your company plan. There are things called child only policies that you could get great coverage for them or a smaller deductible or you know, it has the items that you're looking for, or the network that you're looking for. That's not on necessarily your company insurance. My husband is on the his policy for work, and we absolutely have our own policies outside of him. Keep in mind you subsidies do not apply for this. So it is, you know, there's a difference in premiums, however, we're saving so much on the deductible side versus what his company plan is that it absolutely is a no brainer for us to go off of his company insurance and get our own policies. So look at those child only policies because there's actually plans like Cigna has a lot of states the thing called Cigna enhanced diabetes care plan that actually has $0 payments for preferred insulins equipment, pumps, CGM. So imagine, you know, even if you pay $100 more per month, you know, say $1,200 per year on that premium for that child, but you're it's not subject to a deductible. As a, you know, the company Plan is a $3,000 deductible, you're automatically saving $1,800 Right there, just by switching that person over? No, yeah, really look at those different things, or a lot of states have Medicare type expansion programs, CHIP programs where they'll be, you know, say about 230 $240, but it'll be $0 or $5 prescriptions. So you're just kind of like walked into the Medicaid network, but it's a self pay, like full pay program. And most states have some variation of that. And that can be a lot cheaper than, you know, paying that premium, but still being subjected on a company plan, or even a Marketplace plan to those deductibles. So there's a lot of different affordable insurances. So when I see somebody saying like, Oh, you know, my costs have like, drastically gone up, I'm saying there's ways to mitigate, you know, you just might have to play it differently and not have that four person insurance, it might be just a subscriber on their own company plan. And then other people are on different plans that make more sense for them.

Scott Benner 57:38
And then Medicare, Medicaid, Medicare, Medicare, right.

Samantha Arceneaux 57:42
Medicaid is generally going to be the majority of people under 65. And then over, you know, in the Medicare, those are the senior citizens, so to speak, are on Medicare, Medicare has its own. That's its own topic, Medicare. But that a keyed is generally for people who just do not make a lot of money, especially children. And they really want to make sure that children have some kind of insurance. So what they'll do is if you make X amount of money, say, you know, it's a percentage of the poverty level, if you make that amount, or within like, 200%, you know, you'll pay $0 to $80 a month for that kids insurance. And if you make more than that, then you'll be full pay, which is about 240. Depending on the state,

Scott Benner 58:35
is there insurance for anyone? Like is, are there if you don't have a job, for example, you have no income whatsoever? Is there insurance you can get through the government,

Samantha Arceneaux 58:45
you can try through Medicaid, if you're just making $0 Every day, that's where it gets a little tricky, because every state has different rules and what they expanded upon. So it's hard to give a blanket yes out it's definitely a blanket Look at, look up your state's requirements. But you know, sometimes people feel like, they just can't afford anything. And that's when I keep going back, you know, look at those 340 B programs, just make sure you're getting that at the very least insulin, because nobody should be going without insulin. And, you know, even if it's asking a friend for $20 to go get, you know, a month and a half's worth of insulin from 340 B program, then that's what you have to do but

Scott Benner 59:32
not sucks. I mean, it's it's interesting because you you have this conversation about like what are people with insurance so it's so hard you have to be on the phone with people and bug them about stuff and then you realize that there are far far many people who, who just don't have insurance or cash or any way to get to their their supplies at all. So

Samantha Arceneaux 59:51
exactly. And so, you know, that's it's it's heartbreaking, but you know, it just goes into what advocacy is really Something that is needed, you know, with these insulin caps. I'm very much for them. I know there's a whole conversation that could be had about politics with these days, but just know, even if something hasn't passed, you know, there's always ways to get insulin for cheaper.

Scott Benner 1:00:19
Yeah, it's interesting, isn't it that everybody thought, Oh, we got our politicians to talk about insulin pricing, it's gonna get taken care of and it almost feels like instead it just turned into a fun thing for them to talk about around election time.

Samantha Arceneaux 1:00:31
Yeah. It's it's definitely one of those mouthpieces where everybody wants to say the right things, and then it comes down to actually doing something about it, and then nothing gets done. So that's a little frustrating. But yeah, I would say this is a really good topic, I would say, not just for people with newly diagnosed situations, but for anybody, you know, who's looking to have more affordable health care? You know, I would say it's bold beginning, Scott. But I think, you know, try to to get other people listening, because I get this question from people who've been, you know, having diabetes for years, and they just are so fed up with how much it costs. And, you know, there's definitely ways to save money

Scott Benner 1:01:15
and keep you from having to give up i Well, listen, Sam, I've said it before, I'll say it again, you should be doing this for a living, although I don't know how much anybody that was. The problem is that who's going to a person who's trying to save money, can't afford to pay a person to do something for them to save money. It's, but there's, there's something here, like, this is something that, like, even as you're explaining everything, and going over it, I think this is wonderful information for people to have, but I don't know how reasonable it is to expect that they're going to absorb it and understand that the way you do and then put it into practice, and it would be lovely if they could go somewhere and just say, hey, help me with this. You can have a percentage of what I save, you know what I mean? Like, there's got to be a way to like, make this a mass mass market appeal. Like, you know, I know there's not it seems like leave me alone. I have a job.

Samantha Arceneaux 1:02:06
Yeah, I don't think my I'm actually my husband's assistance. I'm not sure he would love me, separately for him. But

Scott Benner 1:02:14
well, I, you know, back when you first came on the podcast, like, I actually contacted one of the companies I had a relationship with. And I was like, why don't you hire Sam, and put her in charge of helping people get their coverage set up? I was like, you have a problem. Like you have this, you have this thing you're trying to sell to people. One of the impediments you have selling it to them is that their insurance is a blockade? What if you help them get through their insurance. And I don't know if anybody ever took me seriously or not. But I still

Samantha Arceneaux 1:02:41
I actually, before I came on the podcast, I was actually in talks with top manufacturer about that very subject. But unfortunately, it was not a work from home, and I did not want to relocate across the country.

Scott Benner 1:02:53
I'm saying it again, because I know they're listening, it would take you a small department of people. And it would not be a tough process, somebody could contact you would already know they're having trouble because they're working through your customer service people. Yeah, it can be rerouted to this department, which would look at their situation, assess it, and show them what to do to get it taken care of.

Samantha Arceneaux 1:03:13
And honestly, Scott, you know, some of the manufacturer, there's, there's honestly, some really, really good reps out there. So I don't want to discount and say that, you know, the manufacturers don't have reps who are already doing this kind of stuff. You know, that I've seen some really strong appeal letters, some, you know, really unique ways of, of tackling these issues, from the reps and even, you know, taught me something. So, you know, it's not to say that, you know, there's me and me alone in this country doing anything like this, but

Scott Benner 1:03:43
no, I realize that. But yeah, but if I get a bad rep, not a bad rep, what if I get what if I get a new rep, and they just don't know, like, so now it's luck of the draw. I'm paying $200 more because I live in this county. And if I lived in that county that I'd have this rep and they'd know how to file it. Like you don't mean like it just didn't be centralized in my in my in my imagination. But that is not a problem for me to fix. It's just a problem for me to point out. So I've done. Sam, I cannot thank you enough for doing this. You are the last episode of The Little beginning series. Oh, wow. Thank you. You're welcome. That was really a big deal for me to do this for me. And on on late notice, too, because Jenny and I sat down to do this the other day. And I was like, This is wrong. Like, Jenny and I shouldn't be doing this. Like Sam should be doing this. So

Samantha Arceneaux 1:04:30
it's funny. We had talked about doing something like this next summer, and it's October just for reference on when we're recording. And so I got the notice I'm like, Oh, no. I mean, I get prepared. And then I realized, wait a second. I know all of this.

Scott Benner 1:04:43
There's nothing to prepare for your. I apologize to you in public right now for all the times that I tagged you in other people's problems.

Samantha Arceneaux 1:04:50
Oh, no. And it's fine, honestly. And if other people in the Facebook groups want to tag me if they notice something I'm not seeing, you know, feel free to tag I know Nico sometimes does as well. But that's not a problem always happy as long as I see the tag that's usually the only problem is sometimes it gets a little wonky on Facebook but

Scott Benner 1:05:10
Facebook is now giving my giving me my tags a week after they are given like somebody tags me. About a week later I get it. So my notification

Samantha Arceneaux 1:05:18
sometimes you know, it'll it'll come up way later or just I won't see it and I just happen to be scrolling and I'll see myself tag and I'm like, wait a sec. I didn't see this notification.

Scott Benner 1:05:29
Alright, well, Sam, thank you so much for doing this. I really appreciate

Samantha Arceneaux 1:05:32
it. Absolutely.

Scott Benner 1:05:41
Huge thank you to one of today's sponsors, G voc glucagon, find out more about Chivo Capo pen at G Vogue glucagon.com forward slash juice box, you spell that g VOKEGL. You see ag o n.com. Forward slash juicebox. I'd also like to thank Ian pen from Medtronic diabetes to remind you to go to in pen today.com To learn more about it and to get started. And of course, thanks so much to Sam, for coming on and pinch hitting for Jenny here in the bold beginning series. I'm pretty sure there's going to be more bold beginnings coming but yeah, it'd be you know, I'm not sure. Thank you so much for listening. I'll be back very soon with another episode of The Juicebox Podcast. Okay, I'm sick. So I'm going to regret this but I may list all the bulb beginnings episodes for you. 698 Defining bulb beginnings. 702 honeymooning 706 adult diagnosis 711 terminology Part One 711 I just said that 712 terminology part to keep in mind that bold beginnings was a huge collection of statements and input from people who answered the question, what do you wish you knew at the beginning of your type one diabetes diagnosis. So we took all of this feedback, it was literally like 80 pages of feedback and put it into categories and that's what drove the bulk beginning series. So anyway, 711 and 712 is terminology Part One and Two 715 Fear of insulin 719 The 1515 rule 723 long acting insulin 727 target range 731 food choices 735 Pre-Bolus 739 carbs 743 stacking 747 flexibility 751 school, Episode 755 was exercise episode 759 was guilt fears hope and expectations. Episode 763 Community episode 772 journaling 776 technology and medical supplies Episode Seven at treating low blood glucose. This is episode 784. Insurance and there might be more but I mean, that's a lot. So if you can't find them in your podcast player, look for them on the private Facebook group and the feature tab or at juicebox podcast.com. But if you just search bold beginnings juicebox in any of your audio players, they should pop right out. Thank you so much again for listening. I'll be back very soon with another episode of The Juicebox Podcast.