So many of us become comfortable with a daily routine, and if a job change arrives, it may feel as though life has turned upside down. For people living with diabetes, changing jobs may involve more than just finding a parking space, learning the names of your coworkers, or figuring out new job responsibilities. The good news is that planning ahead to anticipate potential problems may help you adapt more quickly to your new situation.
Julie Nance, RD, LDN, CDE*, is a diabetes educator in Virginia and has lived with type 1 diabetes for over twenty years. Her husband is in the military, which has led to numerous job changes for her over the years. Nance strongly recommends finding out the specific job requirements, as well as kitchen or cafeteria amenities available ahead of time to be able to plan for when to eat lunch, snacks, and where to store insulin or other medications, if necessary. She once had a position that entailed quite a bit of overnight travel, which required making adjustments to eating out, bringing supplies with her on the road, and planning ahead to try and avoid lows.
Joan Czarnowski Hill, RD, CDE, LDN, is a nutrition consultant and diabetes educator in Natick, MA. She encourages her clients to think about the timing of meals and breaks before starting a new job. Is there a refrigerator available for your brown-bag lunch? What types of restaurants are close by if you’d rather eat out? If your new colleagues prefer to order in lunch, what are the available options?
Hill also suggests asking about worksite health and wellness programs such as an onsite gym. Plan ahead for changes to your usual exercise routine: will a longer commute mean getting up earlier or switching exercise to after dinner? Will you need to change gym memberships to a facility closer to your new job? If you’re used to walking at lunch with your co-workers, perhaps you can organize a walking group or suggest your new company establish walking programs.
In addition to the changes in your usual daily routine, an important area to consider is health insurance and benefits available at your new company. Requirements to provide coverage for diabetes medications, supplies, and services vary from state to state, and often companies that are self-insured are not required by law to follow these guidelines. The American Diabetes Association provides a wealth of information and resources to help you navigate your choices, including a list of state-by-state insurance options.
Both healthcare and health insurance are going through a period of reform and revision, and guidelines are constantly changing. Portions of the 2010 Affordable Health Care Act are already in effect, and more will be implemented in stages over the next few years. Find the most up-to-date details here, including information on the health insurance marketplace.
Jeannie Stimpfel, medical coder/biller at Rutland Regional Diabetes & Endocrinology Center in Rutland, VT, recommends talking directly with your health insurance company, as well as the human resources office at work to answer these questions:
- Which primary care physicians, endocrinologists, and other specialists are covered? Does the plan require prior authorization to see a specialist?
- Which medications are covered?
- What co-pays and deductibles are required? Are there different co-pays or deductibles with specialists or physicians who are out of the network?
- Which pump supply companies are included?
- What supplies – test strips, glucometer, lancets – are covered?
- Will the company’s insurance plan cover diabetes education classes, appointments with registered dietitians and diabetes educators, gym memberships, or weight loss programs?
If your new company doesn’t provide health insurance or there is a waiting period before health benefits begin, consider participating in the Consolidated Omnibus Budget Reconciliation Act (COBRA), which allows you to, by law, continue with your previous health insurance plan for up to eighteen months. The Life of a Diabetic blogger Chris Stocker has lived with type 1 diabetes for over nine years. He’s used COBRA twice, once in 2009 when he was between jobs that provided health insurance, and again a couple of years later when he was working as a freelancer. Stocker notes that, “COBRA can be expensive, but to me, it was worth the costs because it would have been even more expensive trying to pay for everything out of pocket.” Stocker also recommends that “if you know that you are changing jobs and if you have any fear of losing insurance, stock up on as many supplies as you can, taking care that you don’t go past a product’s expiration date.”
If you have a child with diabetes and your company doesn’t provide health insurance or has a waiting period before the insurance goes into effect, The Children’s Health Insurance Program (CHIP) provides free or low-cost health coverage up to age nineteen for children who may qualify. Eligibility is based on family size and income, and programs vary by state.
Changing jobs may be a major source of stress in your life, but planning ahead may help you more quickly adapt to your new daily routine.
Lynn Grieger, RD, CDE*, cPT is a health, food, and fitness coach; you can follow her at www.LynnGrieger.com and @healthcoachlynn. Grieger is a paid contributor for The DX. All opinions contained in this article reflect those of the contributor, and interviewees, and not of Sanofi US, its employees, agencies, or affiliates.
*“Certified Diabetes Educator” and “CDE” are certification marks owned and registered by the National Certification Board for Diabetes Educators (NCBDE). NCBDE is not affiliated in any way with Sanofi US. NCBDE does not sponsor or endorse any diabetes-related products or services.
© 2013 The DX: The Diabetes Experience