Tools & Resources

Health Insurance Cost Drivers

For people with diabetes who do have insurance, costs of care can still be substantial. As of 2018, the CDC found, 46% of privately insured adults have “high-deductible” health plans—plans that allow beneficiaries to pay lower premiums, in exchange for spending more of their own money before insurance kicks in. 

These plans can be unsafe for people with diabetes and other chronic conditions who require more care, especially low-income beneficiaries who are less likely to be able to afford high out of pocket costs. The total yearly out of pocket expenses for a high deductible health plan can be more than $6,900 for an individual or $13,800 for a family for in-network services. 

One study found that 40% of those on high-deductible health plans delayed care, as compared to 15% on more traditional plan structures.

Those in high-deductible plans also see specialists less and get care in the emergency room more than others. 

There are challenges for patients who are covered by traditional private insurance. Depending on the company and the type of plan an individual has—and particularly for people with diabetes—coverage is highly variable. According to one analysis, extra costs for an insured person with diabetes who requires insulin can exceed $4,800 per year for everything from doctor visits to lost wages.