A Reader Falls Through Medicare’s “Doughnut Hole”


By: Letter from a Reader

Editor:  I am an enthusiastic reader of your magazine. I appreciate the number of timesyou have tackled some of the bigger questions of diabetes management that othershave ignored.

Here is one issue that is of great concern to me: I have been diabetic since1947, using insulin for just about all of those years. The insulin was coveredby some type of medical insurance, including the five years that I used a pump.

Because of site infusion problems (lipoatrophy and hypertrophy), I moved on toinsulin pens and am now injecting long-acting insulin once a day and boluseswith meals.

This worked fine even into Medicare years, but now with Part D coverage and the"doughnut hole," I find myself with no coverage options. Imagine my dismay tolearn that Medicare will cover the cost of insulin delivered through a pump, aswell as all the other expenses incurred by pump users. I continue to pay forinsulin in cartridges and fall into the doughnut hole each year.

The cost of supporting syringe or pen users is miniscule compared to pump users.Has no other reader complained about this? Would you address this in a futureissue?


Alice Allen Erie,

Editor's Note: We welcome comments on Alice's plight.



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