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Beyond Insulin: Medi-Cal Expands Patient Access to Diabetes Supplies

Beyond Insulin: Medi-Cal Expands Patient Access to Diabetes Supplies

June Voros was diagnosed with Type 1 diabetes at age 24. She is on Medi-Cal, California鈥檚 Medicaid program for people with low incomes or disabilities, and feels lucky to have coverage that helps her manage her condition. But she has faced challenges getting supplies on time. (Angela Hart/素人色情片Health News)

LOS ANGELES 鈥 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 attached to her abdomen. The small but powerful device alerts Voros when her blood sugar is dangerously high or low.

鈥淢y blood sugar is at 64. It鈥檚 too low and still dropping,鈥 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 鈥 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 鈥 who is covered by Medi-Cal, California鈥檚 Medicaid program for people with low incomes or disabilities 鈥 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.

鈥淚鈥檝e had to put in hundreds of hours over the phone in the past few years, and I鈥檝e changed my insurance group twice because of this,鈥 Voros said before slugging apple juice in her studio apartment in the Mission Hills neighborhood, a suburban neighborhood in the San Fernando Valley. 鈥淚t鈥檚 exhausting. It makes you want to give up. But I can鈥檛. I鈥檒l literally die.鈥

June Voros is preparing insulin by drawing fluid from a vial with a needle.
June Voros prepares insulin for her pump, which is then attached to her abdomen and delivers a steady stream of insulin to her body. (Angela Hart/素人色情片Health News)
June Voros holds a glucose monitor and shows the photographer its screen.
June Voros, who has Type 1 diabetes, shows her blood glucose reading on a recent day in October, when her level dropped dangerously low. If blood sugar drops too low, patients can have diabetic seizures. (Angela Hart/素人色情片Health News)

Starting in October, Medi-Cal began 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 鈥 ending the scramble to secure separate authorizations for each piece of equipment. Patients can receive 90 days鈥 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.

鈥淏efore, California鈥檚 requirements were four pages long, and now it鈥檚 just a little more than a page,鈥 said Lisa Murdock, chief advocacy officer for the American Diabetes Association, who helped push for the changes. 鈥淭his is a really important step forward. It means not having to constantly guess how blood sugars are doing.鈥

Over the past two years, the state also started making continuous glucose monitors and related supplies available to many more people, including all patients with , a chronic autoimmune disease that attacks insulin-producing cells in the pancreas, and those with , , and , or chronic low blood sugar. Before last year, the monitors were available to only some patients on a case-by-case basis, according to the state Department of Health Care Services, which administers Medi-Cal.

The enhanced coverage extends to newer, more advanced devices, such as the popular , which retail for about $700 on Amazon for a 30-day supply without insurance. Medi-Cal pays for the same equipment.

Diabetes and prediabetes are . About have been diagnosed with diabetes. The Department of Health Care Services says about 1.2 million Medi-Cal enrollees have the disease, according to the latest data available.

June Voros, sitting on a couch in her home, lifts her shirt to show her stomach. She is pointing to a glucose monitor and an insulin pump at her waistline.
June Voros, who was diagnosed with Type 1 diabetes about eight years ago, wears a continuous glucose monitor and an insulin pump at her waistline to monitor her blood sugar and deliver a steady supply of insulin to her body. (Angela Hart/素人色情片Health News)

Before these changes, Medi-Cal recipients had a harder time securing medication and supplies than people with private insurance, Murdock said.

鈥淒iabetes 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,鈥 she said.

Patient advocates and state health officials say the changes will save money and lives by giving those with diabetes more control over their blood sugar, and by preventing complications such as organ failure and foot and toe amputations.

This expansion in coverage 鈥渋mproves access and member outcomes, reduces hospitalizations and comorbidities, and improves members鈥 quality of life with better disease management and less finger sticks,鈥 said Ann Carroll, a Medi-Cal spokesperson. The state, she said, wants to ensure all diabetes patients get 鈥渢he care they need to lead healthy, fulfilling lives.鈥

Before Voros got her monitor about three years ago, she had to visit an emergency room and was hospitalized with . She also lost nerve function in her stomach 鈥 which prevents digestion of high-fiber foods like vegetables 鈥 as her disease advanced.

鈥淚 haven鈥檛 had to go to the intensive care unit in almost two years. It has literally saved my life,鈥 she said.

But the bureaucratic hurdles that kept Voros from getting supplies for her monitor were a constant source of stress. That鈥檚 changing since she switched to a new medical supply company and Medi-Cal has debuted its new preauthorization process, amid a broader revamp of its pharmacy system.

Getting her supplies on time means peace of mind, Voros said.

鈥淚 used to be so afraid to go to sleep at night because of the seizures I鈥檇 get from low blood sugar,鈥 she said. 鈥淚鈥檝e been really close to death, but now I feel better than I ever have.鈥

This article is part of 鈥,鈥 a California Healthline series exploring the impact of the state鈥檚 safety-net health program on enrollees.

This article was produced by 素人色情片Health News, which publishes , an editorially independent service of the .