Does anyone have any advice on how to obtain insulin and other diabetes meds when in the donut hole? Please don't tell me if I use mail order pharmacy services that it's free, which is information that I got on here before, because that simply isn't true. I need helpful advice, not fantasy.

Extra help is thru Social Security. Contact your local Social Security office to apply and see is you are eligible. You have to be very low income to qualify.

Oops, I just re-read my answer and realized I forgot to include the Extra Help link. Mom did qualify for this at one point and it was helpful as far as saving on costs, particularly because she preferred the insulin Flexpens which as mentioned are costly.

I don't know the answer to your questions, however, I am a Type I diabetic and I know how expensive all insulin and diabetic supplies are for out of pocket expenses and I have great health insurance coverage.

I would suggest that you explore Medicaid to see if you qualify. Some people who are disabled receive Medicare AND Medicaid. In this case, they pay nothing for meds, except through their supplemental medication policy, which is paid for by Extra Help, so there is no out of pocket expenses, though, there may be certain brands and devices that they do not cover. But, you can get the basics.

I'm not sure if you have to be disabled or if you can still qualify for Medicaid, if you are receiving regular Social Security and Medicare due to age. Maybe, someone around here who knows can chime in. An expert in your state would ideal to get info from. I might contact a disability attorney who is also familiar with Medicaid. In some states, there has been Medicaid expansion.

Vials of insulin are less expensive than the Insulin pens. While you are seeking prescription coverage from Part D or another source, call your endocrinologist or PCP or whoever prescribes your insulin and let them know you need a less expensive insulin & explain your circumstances. Regular insulin vials are sold at Walmart. If you are on a newer diabetic injectible like Tresiba (24hr acting) you may need to switch back to Lantus or Levemir (Basaglar) & Regular (Novolog, Humalin) in vials vs the pen. You have options to purchase the lesser expensive vial option. I don’t think Tresiba comes in a vial, just a pen and I know this medication is expensive.

As far as glucometer strips and lancets ask your provider for a prescription and take that to Walmart as well.
Insulin pens are very convenient for the person to use but also very costly. You can also check with Medicare or your supplement plan to see If your syringes and strips can be billed through as DME (Durable medical equipment).

While you may not prefer the vials you can use them until your prescription coverage gets settled.

MD offices have lots of samples. When you are discussing your issue with your provider ask them for samples. This can help you get through.

In this case it’s important to meet with whoever prescribed your insulin & get lower cost vial options as you know it is imperative you take your insulin.

Walmart used to have $4 Regular insulin vials but I think the code went up this year. (I heard they were $25 a vial now).

Sometimes the pharmaceutical company for a particular medication has a discount program for those with low income or that meet other requirements. Usually there is an 800 number you can call and they can help you through the process.

Another option you might try is asking the doctor if there are samples or any medications he/she might be able to give you that would help some.

A third option is that sometimes, depending on income, extra help is available for Medicare beneficiaries for prescription drugs. Here is the link to the Web page that lists requirements and has a link to be able to check eligibility. I hope this helps. My mom was insulin-dependent diabetic and I had to research resources for her too, as the costs of insulin can get really expensive, especially in the donut hole.

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