Home InsuranceMedicare Diabetes and Patient Assistance Programs

Helping people age well.

Diabetes and Patient Assistance Programs

by Derrick

diabetes_awarenessDiabetes is a serious condition in which the body does not process food properly for energy.  It is a condition in which a person’s body either doesn’t make enough insulin or is unable to use his/her own insulin in the way it should when dealing with diabetes (source).

There is a high prevalence in seniors with diabetes (diagnosed and undiagnosed) at 25.9%, or 11.8 million according to diabetes.org.  Paying for the cost of medication and testing supplies can be very expensive, especially when an older adult hits the donut hole and the burden of cost falls on his or her shoulders.

Many pharmaceutical companies do offer assistance programs to help pay for the high costs of these important medications.  However, there are so many exclusions that this assistance is often not available to the people who need it the most, senior citizens.  The important thing to know is that the program eligibility for the following assistance programs opens under certain conditions for older adults, such as reaching the donut hole, denial through Extra Help, and meeting income requirements.

These are just a few of the pharmaceutical assistance programs for the treatment of diabetes with links and general information for quick reference.  They are, of course, subject to change based on funding and at the provider’s discretion.

Sanofi-Aventis (Lantus)

Eligibility for Medicare Part D recipients:

  • US citizen or resident and under the care of licensed healthcare provider who is able to prescribe, dispense, and administer in the US
  • Not eligible of LIS (low income subsidy- Extra Help) (link to Extra Help)
  • Have out-of-pocket drug expenses of 5% of your household’s annual income. For example, if your annual household income is $10,000, your individual out-of-pocket drug expenses would have to equal $500 or more.

LillyTruAssist (Humolog, Humolin)

Eligibility for Medicare Part D recipients:

NovoNordisk (Levemir, Novolog, Novolin, Glucagen Kit, Needles, and Victoza)

Eligibility for Medicare Part D recipients:

  • US citizen or legal resident
  • Household income at or below 200% of FPG
  • In the coverage gap (donut hole)
  • Denied for LIS (low income subsidy- Extra Help)
  • Not receiving VA prescription benefits

Interested in assistance through any of these programs?  Check out the links for more details on what is provided through the program, and what is required to complete an application.  A patient’s physician will need to complete a provider portion of the application, patients will need to complete their portion and submit all requested documentation before a decision will be issued.

These programs really do assist patients who qualify and give peace of mind that a choice doesn’t have to be made between utilities, food, or buying prescription medication.  This post is in no way, shape or form medical advice; please speak with your physician for any questions on medications and diagnosis.

You may also like

Leave a Comment