This story was originally published as a guest post in 2 parts for the Type 1 Diabetes Blog I write bi-weekly for Diabetes Sisters.
Before moving to Europe both times, I’ve gotten this question quite often: But how will you get your insulin over there?
While studying abroad in France when I was 21, I brought enough insulin for a 3-month stay. I was to be there for 4 months (which turned in to 9 months but that’s another story for another time), but I was supposed to get my visa by the second month. That visa would grant me health benefits akin to French citizens. However, if you’ve ever lived in France, you know how the French bureaucracy works. Read: slowly. Fast forward to month #3, visa “on it’s way- should arrive within the month,” and I’m cracking open the last of my Humalog supply. Obviously, I had to get more- but how, without insurance, without a visa? Without really speaking French? Without a doctor, or any clue where to begin?
I emailed my study abroad advisor, and asked for her advice. She wasn’t extremely helpful, but she did send me the address to a walk-in clinic in the area. The next day, with a map in one hand and copies of my American prescriptions in the other, I began Mission Insulin.
When I opened the door to the clinic, I was instantly confused.
I was expecting what I am used to in the states: walls lined with clean, comfortable chairs, a plethora of health-related magazines, an unenthused secretary perched behind a wall of glass. There were indeed many chairs lining the walls of the small, stuffy room, but there was no secretary. No clipboard where you sign in, no ticket machine to get a number in line. There were 5 other people in the room, speaking quiet French to each other or coughing or checking the time. Because I didn’t know what else to do, or where else to go, I simply took a seat.
Several minutes passed, and I looked around, growing more bewildered by the minute, as nothing happened. Then finally, a doctor came down the hallway with a patient, shook their hand to say goodbye, and called for the next person in line. So, that’s how that works in France: you just have to know your place in line.
After about an hour, it was my turn. I got up, greeted the doctor in broken French, and followed him down the hallway.
The doctor led me to a large, clean, bright-white room. It had everything that a doctor’s office in the US has, such as an exam table, medical posters on the walls, and sterilization equipment, but it also had a large desk with a computer and several chairs. Luckily, this doctor spoke English. (During my second visit several months later, however, the doctor did NOT speak English, so thankfully by then my French was at a much, much higher level.) I didn’t need an exam, so we went straight to his desk. I told him I had Type 1 diabetes. I told him I took Humalog and Lantus and Freestyle test strips (all of these are available in Europe.) He didn’t ask for proof, for statements from doctors or prior prescriptions. He simply typed it all into the system and printed a prescription paper out for me. He put 2 refills on it and told me to come back when I needed more.
As I stated in Part 1, I didn’t have sécurité sociale (health insurance benefits) yet. In the US, even going to a walk-in clinic located in a tiny room in the back of a drugstore can cost $100 or more if you don’t have insurance. This exchange in France cost 22 euros. If I’d had insurance, it would have been free. In fact, it still was free in the long run, because once I had my insurance, I simply submitted a claim and was reimbursed for my visit. But at the time, I paid the 22 euros directly to him, as his exam room that doubled as a consultation area also tripled as the secretarial office. And with that, I set off for the pharmacy.
Although my walk-in clinic visit had been surprisingly inexpensive, I was still trembling with fear of how much my insulin would cost without insurance, because I know how much it costs in the US and it is absolutely terrifying.
I handed the pharmacist (who also luckily spoke English) my medicine, and she went to get what I needed, which at that time was just a box of 5 insulin pens.
“I don’t have health care here yet…” I said. “But I need to get this now anyway.”
“Oooh,” she gave me a pitying look. “You’re sure it can’t wait? You’re going to have to pay full price. If you had your sécurité sociale it would essentially cost nothing.”
I shook my head, “It can’t wait.”
“Okay then, your total is going to be…” the pharmacist winced, “60 euros.” (Around $67)
I stared blankly at her. “60 euros? That’s it?” She seemed confused by my reaction.
I wanted to say, “I pay more for insulin in the US with insurance, which I also pay an outrageous amount for.”
I wanted to say, “I want to live in France forever.”
I wanted to say, “This makes me incredibly happy and incredibly frustrated at the same time because this is not my country’s healthcare reality.”
Instead, I smiled, handed her 60 euros.”Merci beaucoup.”
“You can get reimbursed for this once you have your sécurité sociale,” she reiterated. I think she felt bad for me. She acted as if it were cruel that I’d had to pay “a lot” of money for medicine to keep me alive, medicine for a disease I couldn’t help having. How thoughtful of her.