diabetes and ins not covering much

Diabetics often have some of the greatest needs for a wide variety of medications and medical supplies on an ongoing basis.
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diabetes and ins not covering much

Postby need help » Tue Mar 24, 2009 2:40 pm

I live in Indiana. My income is between $25,000 to $30,000 a year and I live alone. I do have health insurance but my out of pocket medical expenses are still ranging between $600-$700 per month and has left me struggling financially. Most assistance programs I have found require you to have a lower income, no insurance at all or be on Medicare/Medicaid, or be over a certain age. (I am 26)

I have diabetes and my health insurance will not cover any diabetic testing supplies. The cheapest test strips I have been able to find run about $35 for a box of 50. I use about 150 or more per month. They also only cover a limited amount of syringes and needles.

My medications run between $30 and $100 per month with insurance. They include:

Lantus insulin glargine(rDNA origin) injection, at least 18 units (dosage varies somewhat), 1 x day.

Humalog Pen insulin lispro injection (rDNA origin), dosage varies, 4 x day

Actos, 30 mg, 1 x day.

(Bentyl) dicyclomine 10 mg capsule myl, 1-2 capsule, 4 x day

(Carafate) Sucralfate 1 gr tablet tev, 2 tablets, 2 x day

(Welbutrin) buPROPrion HCL extended release tablets, 150 mg, 1 x day.

ortho cyclen (birth control)

I also take prilosec, 20 mg, 2 x day (Since it is over the counter now my insurance won't cover any of it. If anyone knows of any coupons, etc that would be greatly appreciated.)

I think this is a great idea and I appreciate any ideas or help you could direct me to.
need help
 

Postby need help » Tue Mar 24, 2009 2:47 pm

I forgot to add that any glucose meter will be ok if the strips are reasonable for it.
need help
 

Postby jimithy » Wed Mar 25, 2009 8:27 am

need help,

There are definitely some methods that will provide significant savings for you.

You are right that most assistance programs reject most people... even if they clearly need help affording their medications. There are some programs that might help and I will check into those. Another requirement that can arise is the total number of people in your household (not room-mates) and the approximate combined monthly income of those people (and whether that combined number includes your income or not.) So it would help us to zero in on specific programs that could help you... if you posted that information. It does not reveal any identifying information about you.

It would help us if we knew your monthly costs for each individual medication.

If we knew about how your drug co-pays are determined that might open up some areas to savings. ( i.e. Some insurance plans have a flat rate for all brand name drugs in their "preferred" list (or formulary), a flat rate for all generic medications, and a third rate for brand name drugs not on their "preferred" list. Some insurance plans charge unique prices for every medications. Some insurance plans charge a percentage of the price that the pharmacy sets (therefore choosing the best pharmacy can help.) There are other variations and the best way to save is based upon your specific insurance plan.)

I will quickly put together various ways to provide immediate savings and then based upon whether you provide any of the above information... we can look into methods to save that are specific to your situation.

Thanks for posting and hang in there :-) Help is on the way!

jimithy
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Postby jimithy » Wed Mar 25, 2009 9:10 am

If you have a bit of time then you might want to look through our subject area Diabetes and Disorders & Syndromes You Get Because Of It..

One assistance program for diabetics (that you definitely qualify for) is discussed at Reduced Cost Testing Supplies Program.

There are a number of ways to save discussed here: Specifics About Getting Free or Low Cost Diabetic Supplies.

Part of our "Mission Statement" says: "[b]The National Library of Medicine states, "Physicians have always known that an informed patient who takes an active role is a 'better' patient
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Postby jimithy » Wed Mar 25, 2009 9:30 am

I am the only one replying at this moment because most members check in irregularly and usually late at night. I am sure you will get other responses once members check for posts... and especially if you provide the other information that will allow us to find better ways for you to reduce costs.

I REALLY understand about the high cost of test strips. I use 6 strips a day and I live on Social Security Disability as my only income. When you test a lot then expensive strips can be worse than 90% of the most expensive common brand name drugs. If blood sugar control is a major problem then you do not have the luxury of not testing often. It is more expensive not to test because of hastened major medical problems brought on by poor blood sugar control.

I do not like the choice of... do we eat this month... or do I buy all the test strips I need... or do I just kill myself slowly by not taking care of my blood sugar. None of those options work.

Here are some methods I use to drastically cut my testing costs.

I sign up for every free meters that is offered. (most major manufacturers give out free meters). I find all brand name meters operate about the same and have about the same accuracy. Getting many brands of free meters gives you two methods to reduce costs drastically.

Some of them include some test strips... not a lot, but free is free. The main advantage is that you can buy virtually any brand strip that goes on sale because you will have a meter that uses them.

The more types of current meters you have... the more options you have for reducing your costs with strips. For example... I believe it is pretty safe to buy strips on eBay because they are almost impossible to counterfeit. Just make sure the seller gives you the expiration date, you only buy from sellers with nearly 100% positive feedbacks, AND you only buy sealed BOXES. There is no tamper indicator on almost any bottle of strips so a bottle of strips in an open box could contain out-of-date strips. If you just search the category: Health & Beauty > Medical, Mobility & Disability > Diabetic Aids > Test Strips on a regular basis then you will find deals (especially if you have a variety of meters)

Amazingly, it is possible to get boxes of brand name (unexpired) strips from quality long term eBay sellers with 100% positive feedbacks for only a few dollars a box INCLUDING SHIPPING. Since you are using 150 strips per month... it does not matter that the strips expire soon. If you only buy strips close to expiration... and no more than you will use before they expire then you can get smoking deals.

To get free meters:

First... do not try to get more than one free meter from the same manufacturer (even if it is a different type meter). If they see multiple requests to the same person or address then they will not send any meters.

Most Manufacturers will send you a free meter if you call them and tell them how many strips you use a month (or day). They do not expect to make money on meters... they make the big bucks by selling strips for their meters.

Online Free Glucometer Kits:

For a free FreeStyle Freedom kit or a FreeStyle Lite kit (Usually either will come with 10 strips) go to www.freestylelite.com/freestyleworld/la ... ode=hd74kd

For a free AccuChek Aviva kit with 60 free strips go to www.accu-chek.com/promo/us/usdrtvpromo.htm

For a free One Touch UltraMini (Usually either will come with 10 strips) go to www.onetouchdiabetes.com/ultramini/ and go to the bottom of the page and click "Get the Meter"

For a free ascensia contour go to https://offers.bayerdiabetes.com/Coupon ... ct=contour

Note: Excellent deals on eBay are common but not everyday occurences. I use the "Save Search" feature of eBay that allows me to get an email notice whenever any strip I can use is ending soon with a very low cost. Usually about half of those strips are actual good deals on unexpired strips. That is why I am saying that getting all the free meters you can... it lets you grab more bargains on strips.
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Postby jimithy » Wed Mar 25, 2009 9:38 am

One other PAP (Prescription Assistance Program) that might help is "Rx Outreach" www.rxoutreach.com/eligibility_en.aspx They specialize in higher incomes ($32,490 a year and higher) and are tied with about 55 assistance programs.
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Postby jimithy » Wed Mar 25, 2009 9:58 am

You asked about Prilosec coupons (made by P&G).

You can get probably get a free sample pack from their site: https://prilosecotc.trustedform.com/?sr ... Eh&id=mm22

They have another free sample site at: http://www.pgeverydaysolutions.com/pged ... andsampler

Even using both sites I am not sure you can get more than one free pack... BUT... all your friends and relatives can probably get free sample packs too!

Another P&G site gives out online coupons www.pgesaver.com/Sites/PG_eSAVER/Page/H ... ?src=pgeds

You said you live in Indiana. Another P&G site says that the Sunday newspapers listed below carried a coupon in the March 15, 2009 issue and it is planned to be in the April 5,2009 issues.

1. ANGOLA HERALD-REPUBLICAN
2. AUBURN EVENING STAR
3. KENDALLVILLE NEWS-SUN
4. SOUTH BEND TRIBUNE
5. ANDERSON HERALD-BULLETIN
6. ANGOLA HERALD-REPUBLICAN
7. AUBURN EVENING STAR
8. BATESVILLE HERALD TRIBUNE
9. BEDFORD TIMES-MAIL
10. BLOOMINGTON HERALD-TIMES
11. COLUMBUS REPUBLIC
12. CONNERSVILLE NEWS-EXAMINER
13. ELKHART TRUTH
14. EVANSVILLE COURIER & PRESS
15. FRANKFORT TIMES
16. FRANKLIN DAILY JOURNAL
17. FT. WAYNE JOURNAL-GAZETTE
18. GOSHEN NEWS
19. GREENFIELD REPORTER
20. GREENSBURG NEWS
21. INDIANAPOLIS GANNETT SUNDAY SELECT
22. INDIANAPOLIS STAR
23. KENDALLVILLE NEWS-SUN
24. KOKOMO TRIBUNE
25. LAFAYETTE JOURNAL & COURIER
26. MARION CHRONICLE-TRIBUNE
27. MERRILLVILLE POST TRIBUNE
28. MUNCIE STAR PRESS
29. MUNSTER TIMES OF NORTHWEST INDIANA
30. RICHMOND PALLADIUM-ITEM
31. SALEM LEADER
32. SHELBYVILLE NEWS
33. SOUTH BEND TRIBUNE
34. TERRE HAUTE TRIBUNE-STAR
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Postby jimithy » Wed Mar 25, 2009 10:58 am

You wrote:

I live in Indiana....
I have diabetes and my health insurance will not cover any diabetic testing supplies.


The Indiana Gov site clearly states that health insurance coverage MUST include diabetic supplies.

IC 27-8-14.5-4
Coverage for treatments, supplies, and equipment
Sec. 4. A health insurance plan issued by an insurer must provide coverage to the insured for the medically necessary treatment for diabetes, including medically necessary supplies and equipment as ordered in writing by a physician licensed under IC 25-22.5 or a podiatrist licensed under IC 25-29, subject to the general provisions of the health insurance plan.
As added by P.L.190-1997, SEC.1.
www.in.gov/legislative/ic/code/title27/ar8/ch14.5.html

It looks to me that you need a heart to heart talk with either the Indiana Insurance Commission or your Health Insurance Company.
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Welcome Need Help

Postby Bill-W » Wed Mar 25, 2009 11:05 pm

Need Help,
Thank you for your request.
Ask your doctor if he/she can prescribe Ranitidine instead of Prilosec.
The following doses are available at Wallmart for $4.00/month
or $10.00/90 day supply
Ranitidine 150mg tab
Ranitidine 300mg tab

Also at Wallmart
Dicyclomine 10mg cap
Dicyclomine 20mg tab

Actos Rebate at
http://www.patientassistance.com/coupon-view.html?id=3

Thanks for the post.
We wish you well.
Bill-W
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Postby dlcnurse » Thu Mar 26, 2009 2:52 am

Dear Help,

Thank you for posting. It would be helpful if we had the cost of your co-pay to help us know what you are paying out.

Many of your medications can be purchased online using a Canadian pharmacy vs US pharmacy. Keep in mind that the FDA does not recommend it.

Many of your medications do come in a generic form.
Actos also known as pioglitazone purchased online at a cost of .56 cents/tab = for 90 day supply would cost 60.00

Bentyl which also comes in a generic costs about .16 cents/tab = 100 tablets costing 27.00
Brand name of Bentyl costs .38 cents/tab

Carafate also known as sulcralfate cost is .25 cents/tab so 100 tablets would cost 25.00

Wellbutrin SR for generic is .50 cents/tab for 180 tablets = 90.00
The generic name is Bupropion SR
For brand name the cost ranges from .97 cents to 1.30 per tablet

Prilosec for the prescription is .39 cents per tablet. Your insurance is doing you a disservice as it is cheaper to buy via script. The OTC prilosec runs .51 cents per tablet.
One way to get around that is for the doctor to write on the script "dispense as written" and your insurance can't use the excuse that it can be purchased OTC. They are just getting around it and forcing you to pay the out of pocket expense. But there are other medications that would be cheaper and will give you the same result. Ask your doctor to switch you to a $4.00 script.
Cimetidine (Tagament) comes in 800mg/tab strength at Walmart. For the $4.00 = 30 day supply or $10.00 for the 90 day supply.
Ranitadine (Zantac) comes also under the $4.00 price and also Famotidine (Pepcid) cost at Walmart is $4.00 for a 60 day or $10.00 for a 180 day supply.
The difference in these medications and the prilosec is that they are acid reducers but are not classified as a proton pump inhibitor like the prilosec, nexium, aciphex, protonix are. These drugs are much cheaper in the long run. Because you use your insurance, sometimes these same drugs will cost you more. I don't know what your co-pay is to be able to tell whether it would be more cost effective to purchase these without using your card.
The Bentyl is also available at Walmart for the $4.00 cost.
These may be cheaper for you to purchase without your insurance card. These can be taken in the same dosage as your prilosec.

You might also check out the site http://needymeds.org/free_clinics.taf

They have a list of 64 clinics at which you can get your medications at a much lower cost.
I have not checked yet on your diabetic medications. jimithy already covered some in these areas on ways to lower your cost factor.

Talk to your doctor and ask him about assisting you as well and let him know that you are having difficulty meeting the cost of these medications and ask about switching some of the medications that are cheaper in cost.
Make sure that the pharmacy that you are using is dispensing generic brand.
Do a cost comparison at the different stores in your area. Some of the small Mom and Pop pharmacies will give you the same cost as that of the big Chain stores such as walmart as they don't want to lose business.

I will look at other ways to help you tomorrow as far as your strips/insulins. A point of interest is that while the PENS are easier to use, purchasing the vial is much cheaper.
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