Help with Your Diabetes Prescription and Insulin Costs

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All people with T1D should have affordable access to insulin. While sharing the resources below that can help with costs, JDRF is also fighting for changes from manufacturers, health plans, employers and the government to make insulin more affordable. Learn more here. 

Prescription costs for drugs to treat type 1 diabetes (T1D) can make up a large percentage of what you pay each year for healthcare. There are a few ways you can lower your prescription and insulin costs: through state and nonprofit programs; diabetes patient assistance programs offered by pharmaceutical companies; medication discount cards; and prescription alternatives such as biosimilar insulin.

In this section we’ll discuss

“I honestly think I got the most help from calling the manufacturer’s assistance programs. They have a really good grip on how their products are covered, and they gave me great advice on how to lower my costs.”
—T1D patient, WY

Nonprofit Patient Assistance Programs for Type 1 Diabetes

There are a number of patient and insulin assistance programs available to help with the costs of your medication, many of them run by nonprofit organizations. They include the following:

  • FamilyWize is an organization that offers a no-cost prescription discount card and a website that helps you find the pharmacy with the lowest cost for your prescriptions.
  • Partnership for Prescription Assistance is a program sponsored by pharmaceutical companies, doctors, patient advocacy organizations and civic groups that helps low-income, uninsured patients get free or low-cost brand-name medications.
  • NeedyMeds is a nonprofit organization that maintains an extensive database of patient assistance programs, state assistance, medication discount programs and free or low-cost medical care. You can search its database for free. The site also has information on thousands of programs to help consumers through the application process.
  • RxAssist is an online database of pharmaceutical company programs that provide free or affordable medicines and co-pay assistance.
  • RxHope is a web-based resource where you can search by medication to locate assistance programs. It also offers help with the application process.
  • RxOutreach is a nonprofit mail-order pharmacy for uninsured or underinsured people.
  • The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) also has a publication called “Financial Help for Diabetes Care,” which offers information about resources that may help with medical expenses of a person with diabetes. You can view this publication online or order copies from the National Diabetes Information Clearinghouse at 1-800-860-8747.

Pharmaceutical Company Patient Assistance Programs

You may be able to get help with the costs of insulin and medication through drug assistance programs from pharmaceutical companies, known as patient assistance programs (PAP). Each program has its own eligibility requirements for people with type 1 diabetes, so it’s important to check those details. Here are a few programs offering assistance for diabetes medications:

Leading pharmaceutical companies have also created the Together Rx Access Card to help people without other prescription drug insurance coverage gain access to savings on prescription products. The Together Rx Access Card offers 25 to 40 percent off brand-name prescription medications at pharmacies nationwide. To learn more about the card, visit the Together Rx Access Card website or call 1-800-444-4106.

You can also find a program by searching on the medication name here.

If you need assistance with your pump supplies or CGM, directly contact the manufacturer via their customer service number.

  • Medtronic: 1-800-646-4633
  • Tandem: 1-877-801-6901, option 3
  • Insulet: 1-800-591-3455
  • Dexcom at 1-888-738-3646
  • Abbott Diabetes Care*: 1-835-632-8658

*Abbott Diabetes Care CGM products are not currently FDA approved for use in pediatrics.

Pharmaceutical Company Co-Pay Coupons

Co-pay coupon cards can be used by anyone, regardless of income, to reduce your out of pocket costs at the pharmacy. They often can be used for one or two years before you must re-sign up. One catch to using these coupons is that to the costs they cover may not count toward your deductible or out-of-pocket maximum. Also, you may not use these coupons if you have Medicare, Medicaid, Tricare or other government health insurance. Read the details for each coupon to determine if the coupon will work for your situation.

You can find more information about each of the coupons here:

If you do not have prescription medication insurance and are paying cash:

State-Based Patient Assistant Programs for People with Type 1 Diabetes

Many states also offer medication assistance programs for people with chronic conditions like type 1 diabetes. These programs vary greatly by state, so make sure to check the program criteria. Search what’s available in your state here.

Other Options for Low Cost Insulin

A number of national drug store and pharmacy chains also have their own prescription programs to help customers save money on certain medications. Stores with these programs include Costco, CVS, Kmart, Rite Aid, Target, Walmart, and others. Speak with your pharmacist at any of these stores for details.

Community Health Centers

Community Health Centers are health care providers that provide medical care for anyone, with or without insurance and with a sliding scale payment option (your cost to use the center is tied to your income).  A list of these health centers can be found here: https://findahealthcenter.hrsa.gov.  They can help you access insulin or other prescriptions at a reduced cost.

Ask your physician for samples

If you are struggling to afford insulin, be sure to tell your health care provider. Your primary care provider or endocrinologist may have insulin samples available in their office.  They also can help you find ways to reduce your costs by writing a larger quantity prescription, changing brands or formulas or documenting your medical needs for other assistance programs.

Older formulations of insulin

If you are in immediate need of insulin and have no health insurance coverage and limited funds, it is possible to obtain very affordable older types of insulin over the counter from Walmart or Sam’s Club.  This insulin is sold under the ReliOn name and costs $25 for a 10mL vial.  It works differently than newer insulins, so you will need to learn how to dose it correctly.

 

JDRF maintains a forum where insurance issues can be discussed.
If you have questions for the community, you can post them here!

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