Low Cost Diabetic and other supplies


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Low Cost Diabetic and other supplies

  1. 1. LOW COST DIABETIC AND OTHER MEDICAL SUPPLIES Abbott Diabetes Care Patient Assistance Program This program assists financially disadvantaged individuals who meet certain income criteria. Applications are available by calling 1-800-222-6885 or visiting www.abbottpatientassistancefoundation.org If you are able, get a Medicaid denial letter for your patient in advance. IPump.org, Inc. www.ipump.org Offers limited reimbursement for diabetes medications, supplies, and insulin to persons who qualify under their Emergency Request for Medical Assistance program. They also offer limited monthly financial assistance to qualifying persons to help cover the cost of insulin, diabetes medications and supplies. Persons may only receive financial assistance through one program and no more than once per year. Under their "REDS" program eligible persons may receive certain free diabetes and insulin pump supplies. Contact the Assistance Program Director, program-director@ipump.org for more information about programs currently funded. Islets of Hope www.isletsofhope.com/diabetes/assistance-programs/main_1.html Lists comprehensive assistance programs by state, as well as international resources for other countries. Includes private, corporate, and government programs. BD Insulin Syringes Program http://www.bddiabetes.com/us/hcp/ Physicians may order syringe and pen needle sample packs by fax or phone: 1-888-367-9539. Diabetes supplies sales representatives Many advocates working in clinics or other medical settings suggest contacting the sales representative for those companies that manufacture brand name monitoring and/or testing supplies. Together RxAccess This drug discount card is sponsored by major pharmaceutical companies. The card is free and offers a 25%-40%* discount on brand-name and generic prescription drugs as well as other prescription products, such as glucose test strips. Compiled and updated by RxAssist, May, 2009
  2. 2. To qualify: • Not eligible for Medicare. • No prescription drug coverage of any kind. • Household income is equal to or less than: $45,000 for a single person $60,000 for a family of two $75,000 for a family of three $90,000 for a family of four $105,000 for a family of five • Must be a legal US resident Discount medical supply companies/local retail stores There are many companies advertising on the Internet. The cost of supplies can vary greatly, so you may want to ask local clinics or pharmacies for recommendations or how to select among companies. Discount chains also offer diabetic supplies that may be competitive with mail order firms. For example, Wal-Mart’s ReliOn brand meters and strips are made by a division of Abbott and their ReliOn brand Novolin N, R & 70/30 insulins are made by Novo-Nordisk. INFORMATION FROM THE FDA ON THIRD PARTY TEST STRIPS Third-party or "generic glucose reagent strips" are test strips developed as a less expensive option than the strips that the manufacturer intended the meter to be used with. They are typically developed by copying the original strips. Although these strips may work on the meter listed on the package, they could look like strips used for other meters. Be sure the test strip you use is compatible with your glucose meter. Sometimes manufacturers change their meters and their test strips. These changes are not always communicated to the third-party strip manufacturers. This can make third-party strips incompatible with your meter without your knowledge. Differences can involve the amount, type or concentration of the chemicals (called "reagents") on the test strip, or the actual size and shape of the strip itself. Meters are sensitive to these features of test strips and may not work well or consistently if they are not correct for a meter. If you are unsure whether or not a certain test strip will work with you meter, contact the manufacturer of your glucose meter. Compiled and updated by RxAssist, May, 2009
  3. 3. Medicare and Diabetic Treatment (from Medicare and American Diabetes Association websites) For Medicare beneficiaries, Part D covers insulin-related supplies such as syringes, needles, alcohol swabs, and gauze. Medical supplies such as meters, test strips and lancets are covered by Part B. All American citizens over age 65, the disabled, and individuals with end- stage renal disease who purchase Medicare Part B coverage and/or Medicare managed care policies are eligible for the following: Blood glucose testing supplies Blood glucose monitors Blood glucose test strips Lancets Spring loaded lancet devices Glucose control solution for calibrating meters However, some limitations apply, including: • All patients with diabetes are entitled, upon receipt of a physician’s prescription, to a blood glucose monitor for the life of the monitor. • Patients treated with insulin are eligible for 100 blood glucose test strips and 100 lancets per month. • Patients not treated with insulin are eligible for up to 100 test strips and 100 lancets every 3 months. • Physicians may prescribe more test strips, but they must document their patients’ need for additional testing supplies in writing. A physician must renew documentation of this need every six months. In order to receive coverage for blood glucose test strips and related supplies, a prescription must be written by a physician. This prescription must meet the following guidelines: • The prescription must be renewed every six months. • The prescription must clearly document the number of strips and lancets to dispense. • The prescription must document whether or not the patient uses insulin to manage diabetes. • The frequency with which the patient should monitor their blood glucose level or use the supplies must be clearly identified. NOTE: This point is extremely important as Medicare will not accept prescriptions that state monitoring should occur or supplies should be used "as needed." Compiled and updated by RxAssist, May, 2009
  4. 4. • Insulin Pumps and Supplies for Use with a Pump Medicare now covers insulin pumps, single and multiple use medical supplies for use with a pump, and insulin for insulin pump users. Medicare restricts coverage for insulin pumps and related supplies to enrollees who use insulin to manage their diabetes. Furthermore, Medicare limits use of pumps to those who have results on a medical test known as a c-peptide test that is within a certain range. Patients must obtain a prescription from their physician for the pump and its supplies and must also go through a diabetes education program in order for Medicare to cover the pump and its related supplies. Diabetes Education & Medical Nutrition Therapy Medicare now covers diabetes education services, also known as self- management training and medical nutrition therapy for enrollees with diabetes. Upon the diagnosis of diabetes, or one-time as an enrollee in the Medicare program, a Medicare enrollee is entitled to receive 10 hours of diabetes education. When prescribed by a physician and provided by an appropriately recognized healthcare provider or program, this education will usually occur in a group setting. After this initial training and when prescribed by a physician, a patient can receive up to 2 hours of additional training each year. A physician can also order medical nutrition therapy for a patient with diabetes. A physician can order up to 3 hours of medical nutrition therapy for a patient with diabetes in the first year of diagnosis and 2 hours a year in subsequent years. Co-pays and Deductibles Deductibles and co-pays for an enrollee's Medicare Part B policy will often apply to the described benefits. The deductibles generally require an enrollee to pay for the first $100 of care purchased in a calendar year. After reaching the deductible, a Medicare enrollee is typically required to pay 20% of all charges for items and services while Medicare pays the remaining 80%. Patients with Medigap, other forms of supplemental insurance including Medicaid or those enrolling in a Medicare HMO are generally not responsible for these deductibles and co-pays. Supplemental policies like these typically cover the usual Medicare Part B deductibles and co-pays within the parameters of the supplemental policy’s insurance program. You can access Medicare or call 1-800-638-6833 for more information about Medicare coverage. Compiled and updated by RxAssist, May, 2009
  5. 5. Institutional discounts NeedyMeds has a program to assist non-profit or government agencies with free diabetic and over the counter medications. The products provided are new although some of packaging may be damaged. The provider of the supplies guarantees the products are in good condition and function as designed. The products are sent to clinics only. To participate clinics must be a 501(c)3 non-profit organization, an educational institution, or run by a governmental agency; provide direct services and on site treatment to patients; and have a licensed healthcare provider (MD, DO, PA, RN, Nurse Practitioner, or pharmacist) available to receive and distribute the supplies. NeedyMeds will email the clinics when items are available. Each clinic will email its request for supplies. NeedyMeds will determine which items are sent to each clinics. The products will be directly from the donor's facility. See www.needymeds.com/supplyassistance/sapintro.tml The 340B Drug Discount Program offers test strips for entities participating in the program. Only certain designated entities, such as Federally Qualified Health Centers, Health Care for the Homeless, et al. with pharmacy services are eligible for the 340B Drug Discount Program. For more information on the program, visit: http://www.hrsa.gov/opa/introduction.htm The Free Clinics of the Great Lakes Region offers a discounted bulk purchasing program for test strips, Volume Rx, for free clinics. For more information visit http://www.fcglr.org/home_frame.htm The National Association of Free Clinics offers discounted test strips for its members. For more information visit www.nafclinics.org Medicare For Medicare beneficiaries, Part D covers insulin-related supplies such as syringes, needles, alcohol swabs, and gauze. Medical supplies such as diabetes testing supplies including meters, test strips and lancets are covered by Part B. For a chart on diabetes related coverage visit: http://www.medicarerights.org/diabetescoveragechart.html Compiled and updated by RxAssist, May, 2009
  6. 6. OTHER SUPPLIES/MEDICAL EQUIPMENT If an individual has a specific disease or chronic condition, it is always a good idea to check out the local chapter of the national non- profit organization representing that condition. Local chapters may have specific programs or funds available to assist with treatment, supplies, etc. The following national organizations either provide financial assistance to patients or have local chapters that may do so. • CancerCare at: www.cancercare.org or 1–800–813–4673. • Leukemia and Lymphoma Society at: www.leukemia- lymphoma.org or 1–800–955–4572. • American Cancer Society at: www.cancer.org or 1–800–227– 2345. • American Kidney Foundation at: www.kidneyfund.org or 1-866-300-2900. Where can I find braces, prosthetic devices or assistive technology for the uninsured? • Limbs for Life at www.limbsforlife.org or 1-888-235-5462 • The Barr Foundation Amputee Assistance Fund at www.oandp.com/barr or 561-394-6514 • Local Independent Living Resource Centers; find at www.virtualcil.net/cils/ • Many local Easter Seals organizations loan equipment to individuals. Check with yours for available programs. Contact www.easterseals.com/site/PageServer or 800-221-6827 • Other local service based charities, such as United Way, Catholic Charities, Jewish Family and Children’s Services, Lutheran Social Services, etc. Where can I find colostomy supplies for the uninsured? • Convatec at at 1-800-422-8811 or Hollister Company at 1-800-323-4060. These companies may help on a case by case basis. • United Ostomy Association of America at www.uoaa.org • American Cancer Society at www.cancer.org Compiled and updated by RxAssist, May, 2009
  7. 7. These organizations may be able to put you in touch with local suppliers who might be willing to donate supplies. Where can I find eyeglasses for the uninsured? • New Eyes for the Needy at www.neweyesfortheneedy.org/us/us.html • Vision USA at www.aoa.org/x1061.xml • Local Lions clubs; find at www.lionsclubs.org/EN/index.shtml# • For uninsured children, contact Sight for Students at www.sightforstudents.org Where can I find hearing aids for the uninsured? • Hear Now, at www.sotheworldmayhear.org/hearnow/ • Local Independent Living Resource Centers; find at www.virtualcil.net/cils/ • Local Lions clubs; find at www.lionsclubs.org/EN/index.shtml# Where can I find oxygen supplies for the uninsured? • American Lung Association at www.lungusa.org or 1-800-LUNGUSA • Local suppliers of durable medical equipment who might be willing to provide donated or reduced cost oxygen. Where can I find sleep apnea supplies for the uninsured? • American Sleep Apnea Association at www.sleepapnea.org or 202-293-50 • Local support groups may have programs that can offer assistance. • Local sleep clinics, pulmonology practices, pharmacies that sell medical equipment or medical equipment suppliers. These entities might donate new or used equipment (e.g., from a patient who has upgraded.) Compiled and updated by RxAssist, May, 2009
  8. 8. Compiled and updated by RxAssist, May, 2009