Financial concerns are common among seniors. Many elders are on a fixed income and find it difficult to purchase basic necessities such as food, clothing, and proper shelter. Some older adults may also be providing for the needs of another family member or friend or may be raising grandchildren as well.
According to the National Committee to Preserve Social Security and Medicare’s article entitled “Senior Income Statistics,” the average income for seniors was $29,248 with an average poverty rate of 9.7% in 2008. Financial concerns such as the cost of health insurance, diabetic supplies, and hidden costs are important barriers to consider when planning effective diabetes care for seniors.
Cost of Health Insurance a Barrier to Diabetes Treatment in Seniors
Although many American seniors have Medicare and many other countries offer affordable or free health insurance to the elderly, not all older adults have quality affordable health insurance. Some older adults who are willing to pay out of pocket cannot find affordable health insurance, particularly if they have a pre-existing condition like diabetes.
Seniors with health insurance may experience caps or limits on coverage, deductibles, co-pays, referral requirements, limited choices for quality healthcare providers, coverage gaps for medications and other supplies, required documentation for reimbursement, skyrocketing premiums, long wait times when trying to seek information on the telephone, and more. Some may feel that the “red tape” involved in properly treating a complicated chronic condition like diabetes is not worth the effort
According to the American Diabetes Association’s article by Katie Bunker entitled “Health care reform: What to expect from the new law,” insurance companies in America should make coverage available to adults with pre-existing conditions like diabetes in the same manner that they offer coverage to adults without pre-existing conditions by 2014. President Obama’s American Health Benefit Exchanges are also expected to begin offering health insurance options with a set of minimum benefits to small businesses and individuals.
Future healthcare reform plans in America may also result in a more proactive, rather than reactive, approach to healthcare. Preventive health care is typically much less expensive than treating diabetes complications and can produce a win-win situation for the insurers as well as the insured. According to Ms. Bunker’s article, employers may start offering incentives to make healthy lifestyle choices, such as smoking cessation and maintaining a healthy weight, in worker wellness programs.
Cost of Diabetic Supplies and Medications May be Too High for Elders
Although many diabetic-related health supplies may be completely or partially covered by insurance, uncovered costs and hidden expenses can quickly add up for someone on a tight budget.
Prevention and management of diabetes and related complications can involve the care of several different healthcare providers, such as a primary physician, nutritionist, podiatrist, optometrist, dentist, wound specialist, and more. Scheduled and unplanned visits to multiple specialists may involve a variety of out-of-pocket expenses, such as:
- co-pays for direct care, lab tests, medications, supplies, etc.
- transportation costs, including gasoline and maintenance
- meals away from home
- lost wages of the senior and/or a caregiver
Special supplies for prevention or treatment of complications can be costly, such as:
- diabetic testing supplies
- special shoes, inserts, and/or socks
- frequent screenings, such as those for glaucoma and dental appointments
Some medical supplies may be designed with special needs in mind. These devices have adaptations to help a senior to overcome functional limitations and become more independent, but they might cost more and may not be covered by insurance. Here are a few examples:
- talking glucose meter
- insulin pens
- aids to help prevent bending a needle when pulling up insulin
- products to help a senior put on socks and shoes
- mobility aids, such as a scooter or electric wheelchair
Older adults may incorporate simple and inexpensive techniques to help overcome some financial limitations, but they may not be given specific, practical pointers, such as:
- using a clothespin to hold a glucose monitoring strip
- placing diabetic supplies on a tray with a non-slip surface
- using adequate lighting in the home
- using a magnifier or requesting larger print to assist with reading directions, medication vials, etc.
- requesting easy-open medication bottles at the pharmacy if children are not in the home
- asking the physician about generic and less expensive options for medications
Extra supplies may need specific documentation in order to qualify for additional funding. For example, a senior might need to more frequently check blood sugar levels, but insurance might not cover those extra supplies without specific documentation. An older adult may not be readily equipped with senior-friendly forms for record-keeping.
Seniors May Find a Healthy Lifestyle to be Cost Prohibitive
Maintaining a healthy diet may be more costly than eating one that is less healthy. A senior may find it difficult to cook quality healthy meals only for herself and may instead make less healthy food choices when grocery shopping or going out to eat. A senior with limited mobility due to a condition like arthritis may need kitchen appliances to assist with movements like chopping and slicing, but those devices might be out of his price range. Seniors may be unaware of inexpensive and healthy dining and grocery options available to them.
Finding a safe place to exercise might be expensive for a senior. Most gyms require a joining fee and a monthly fee for the use of the facility, and some offer more senior-friendly exercise options than others. Home gym equipment and exercise videos, such as the Wii, may be difficult for a senior to purchase and safely use. Seniors may be more likely to maintain a regular exercise routine if reasonably priced or free exercise programs are available, such as the Silver Sneakers program or walking programs at a safe location like a local mall.
Diabetes Care and Prevention Carries High Price Tag for Seniors
Although some diabetes-related supplies and treatments may be covered by insurance, seniors often foot the bill for uncovered and hidden costs. Lifestyle changes may be costly as well. Costs related to preventive and consistent treatment of diabetes, although usually worthwhile in the long-term, may place a strain on already limited funds and can quickly create a barrier to effectively treating diabetes in older adults.
This article is for informational purposes only and should not be considered medical advice.