“Diabetes is a really heartbreaking and costly disease, and to take care of themselves, people with diabetes need easy access to insulin, but also the supplies to manage the disease….”
Beyond Insulin: Medi-Cal Expands Patient Access to Diabetes Supplies
LOS ANGELES — June Voros sprang from her couch as a high-pitched beep warned her that she needed a quick dose of sugar.
Her blood sugar was plummeting, and the beep came from a continuous glucose monitor attached to her abdomen. The small but powerful device alerts Voros when her blood sugar is dangerously high or low.
“My blood sugar is at 64. It’s too low and still dropping,” Voros, 32, said on a bright October afternoon. She checks the monitor up to 80 times a day to help prevent complications from Type 1 diabetes.
But the monitor means little without the supplies that make it work, including a receiver, a sensor, and a transmitter — some of which must be replaced every 10 to 30 days. Voros also has an insulin pump, which delivers a steady supply of that hormone to her body, and it requires supplies too.
Until recently, Voros — who is covered by Medi-Cal, California’s Medicaid program for people with low incomes or disabilities — spent countless hours on the phone with her endocrinologists, her Medi-Cal insurer Health Net, and a medical supply company to obtain separate approvals for each item. At times, her authorizations expired too quickly, leaving her short on supplies and forcing her to ration and seek donations on social media from other diabetes patients.
Last year, she received only enough supplies to last six months.
“I’ve had to put in hundreds of hours over the phone in the past few years, and I’ve changed my insurance group twice because of this,” Voros said before slugging apple juice in her studio apartment in the Mission Hills neighborhood, a suburban neighborhood in the San Fernando Valley. “It’s exhausting. It makes you want to give up. But I can’t. I’ll literally die.”
Starting in October, Medi-Cal began relaxing prior authorization requirements that have caused life-threatening delays for Voros and others with diabetes.
Previously, authorizations for medications and supplies lasted six months, though for some patients, like Voros, they expired sooner. Under the new rules, authorizations are supposed to last one year from the date of approval and can include all needed supplies — ending the scramble to secure separate authorizations for each piece of equipment. Patients can receive 90 days’ worth of supplies and medications at once.
The state is also formalizing a policy that allows patients to obtain approvals from their health care providers by phone or video.
“Before, California’s requirements were four pages long, and now it’s just a little more than a page,” said Lisa Murdock, chief advocacy officer for the American Diabetes Association, who helped push for the changes. “This is a really important step forward. It means not having to constantly guess how blood sugars are doing.”
This article is part of “Faces of Medi-Cal,” a California Healthline series exploring the impact of the state’s safety-net health program on enrollees.
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