Get Help with Diabetes Treatment and Insulin

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| 8 min read Financial Assistance

Diabetes is a chronic disease that touches the lives of almost everyone in the United States, and over 38 million Americans are living with diabetes. Millions more care for or know diabetics, and know the struggle of getting help with diabetic supplies. One of the biggest challenges is the rising cost of insulin, but that’s not the only expense. According to a review published by the American Diabetes Association (ADA) in Diabetes Care, “On average people with diabetes incur annual medical expenditures of $19,736, of which approximately $12,022 is attributable to diabetes.” For diabetics, these costs can include insulin, insulin pens, insulin pumps, glucose meters, continuous glucose monitors, blood lancets, blood sugar level test strips, ketone test strips, glucagon, and more.

As you can see, these costs can really pile up, representing a significant yearly outlay. Millions of Americans are looking for ways to ease the financial burden of diabetes. In this article, we’ll look at ways to get financial help with diabetic supplies and ways to reduce your costs.

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1. Health insurance

There are many ways to reduce your costs for diabetes treatment and insulin, and one of the best is to utilize a health insurance plan. There are two broad types of health insurance – private and government.

Private health care coverage

There are a few different types of private healthcare plans. In a group plan, an insurance company provides coverage to an entire group or organization. Most often, a group plan is all of the employees of an entire company. In an individual plan, a person purchases insurance directly from the insurance provider, sometimes with the help of the health insurance marketplace.

Private healthcare companies offer many different plans, each containing specific language describing its coverage for diabetic care, medication, and testing supplies. You’ll want to review the options available to you to understand what your monthly premiums, deductibles, co-insurance, and out-of-pocket costs are. You should also understand what your copayment costs are should you need to see a doctor or visit a medical office.

Government health insurance plans

There are also a variety of government health insurance plans that can provide some help with diabetic supplies and costs.

Medicare

Medicare is health insurance for those 65 and older, and for those who have a disability or certain diseases. Medicare health plans provide hospital insurance (Part A) and medical insurance (Part B). They can also include Medicare Advantage Plans (Part C), Medicare Cost Plans, and Program of All-inclusive Care for the Elderly (PACE). Private companies that contract with Medicare offer these plans. Prescription drug coverage (Medicare Part D) is also available. According to Medicare.gov, costs for Part D-covered insulin are now capped at $35 per month, representing a significant cost savings. With Part B, you get coverage for insulin pumps, which are seen as medical equipment.

Medicaid

Medicaid is a state and federal program that helps cover medical costs for those with limited income and resources. Each state runs their own Medicaid program, following the general rules set forth by the federal government. To see if you qualify for Medicaid, you can apply directly with your state or through the Health Insurance Marketplace.

Children’s Health Insurance Plan (CHIP)

For children, a government insurance option is the Children’s Health Insurance Program, or CHIP. CHIP can provide low-cost health coverage to children of families who earn too much money to qualify for Medicaid. Similar to Medicaid, CHIP is a state-run program, and each state will have its own rules that detail who qualifies for coverage. CHIP benefits can vary by state, but states must provide comprehensive coverage that includes routine check-ups, doctor visits, prescriptions, emergency services, hospital care and more.

TRICARE

TRICARE is a healthcare program for service members, retirees, and their families. It offers comprehensive coverage that includes health plans and prescriptions. TRICARE also covers related supplies and equipment that are needed for diabetes management, such as insulin products, blood glucose strips, diabetic syringes, needles, lancets, continuous glucose monitoring systems (CGMs) and more. All of these may fall under a medical benefit, a pharmacy benefit, or both. To learn more about coverage and eligibility, visit the TRICARE website.

2. Crowdfunding for diabetic supplies and insulin

While insurance can cover many diabetic supply costs, you may need to find a way to supplement insurance. Crowdfunding can help you fill this gap. With crowdfunding, you can harness the power of your network while reaching an even larger audience. GoFundMe takes the stress out of starting a fundraising campaign, making it easy to set one up for yourself, a family member, or a friend. We’ve worked with millions of people to help them make successful fundraising campaigns, and we know how important it is to have access to the money you’ve raised. That’s why there are no long waiting periods to receive your funds, so you or your loved one can get the help they need for diabetic supplies quickly.

3. Prescription assistance programs

In addition to insurance coverages, another way to lower your costs for diabetes supplies and insulin is to utilize prescription assistance programs. These programs can help you lower your costs for the supplies you use. There are a number of financial assistance programs available, including pharmaceutical assistance programs, co-pay assistance programs, and nonprofit assistance programs.

Pharmaceutical assistance programs

Many pharmaceutical companies offer pharmaceutical assistance programs (PAPs) that help patients who can’t afford their diabetes medications receive discounted or free products. When it comes to diabetes care, almost every major manufacturer offers some sort of program. Here’s a list of many pharmaceutical assistance programs:

Co-pay assistance programs

Co-pay assistance programs are another way to reduce diabetic medication costs. These programs offer insulin and other medications at a discounted cost, regardless if you have commercial insurance or no insurance. There are restrictions to these programs for those enrolled in government insurance programs. Some programs include:

Nonprofit assistance programs

There are many nonprofit organizations that also provide ways to receive reduced-cost diabetic care. These programs include:

  • Medicine Assistance Tool (MAT) – This tool is a search engine that details the biopharmaceutical industry resource programs.
  • NeedyMeds – This nonprofit connects patients to programs that can help reduce medical costs.
  • RxAssist – This nonprofit serves as a database, compiling many patient assistance program details and additional information.
  • RxHope—This organization serves as a guide, helping patients find the information they need and directing them to the proper patient assistance programs.
  • GetInsulin.org – This organization provides resources for those who need help finding and affording insulin products.

Community health centers

Another organization that can provide low-cost medical care for diabetes is a community health center (CHC). CHCs are federally supported healthcare providers and deliver care to underserved and medically disadvantaged patients. They offer low-cost or free services to those who have insurance coverage and free services or a reduced-cost, sliding-scale fee for patients who do not. You can use the Health Resources and Services Administration tool to find a CHC near you.

4. Practical considerations to save money

In addition to the options listed above, there are some other ways you can look to reduce your diabetes and insulin costs.

Switching to a generic or biosimilar option

Sometimes, switching to a generic prescription or a biosimilar option can help you reduce the costs of your medications. Generic medications are the same drug as the FDA-approved brand name, simply without the brand name attached to the drug. In contrast, a biosimilar drug is not the same as an FDA-approved drug but works the same way in the body. In 2020, the FDA allowed insulin products to be classified as biologics, which created a new regulatory pathway for biosimilar insulins to get approved. Currently, there are two approved insulin biosimilars – Semglee, which is interchangeable with Lantus, and Rezvoglar, which is also similar to Lantus but made by Lilly. Talk to your healthcare professional about the feasibility of making these switches to see if they are right for you and can help lower your costs.

Switching to a 90-day prescription

Another practical way you may be able to lower your medication costs is to switch from a 30-day supply to a 90-day prescription. By switching to a prescription that lasts longer, you can reduce the amount of copay payments you need to pay. These copayments can add up, so talk with your pharmacist about the potential savings and steps you can take to convert your prescription to a 90-day supply.

If you’re struggling to pay for your diabetes treatment and insulin, know that you’re not alone. From utilizing generics to assistance programs to crowdfunding, there are many ways you can get help and lower your costs. If you decide crowdfunding is right for you, GoFundMe is ready to help. Putting together a fundraising plan can help you create a successful fundraiser. With GoFundMe’s platform, you can amplify your story to a bigger audience and get the help you need for your diabetic treatment costs.

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