Diabetes Self-Management Articles

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Diabetes and the Downturn
Getting Care During Tough Times

by Gabrielle Kaplan-Mayer

  • The Charles Ray III Diabetes Association, Inc., provides blood glucose meters, strips, and other supplies to those who can’t afford to pay for them. To apply for assistance, log on to www.cr3diabetes.org/.
  • The Patient Advocate Foundation Co-Pay Relief Program assists people who have chronic illnesses — including diabetes — and are fully insured but who struggle to afford their insurance co-payments. To apply for assistance, go to www.copays.org or call (866) 512-3861.
  • NeedyMeds (www.needymeds.org) is a nonprofit Web site that offers free, anonymous advice to anyone who cannot afford needed medicine or health care. The Web site helps visitors find both low-cost medicine programs and disease-based assistance programs.
  • Local charitable organizations, including the Lions Club International, Rotary Club, Elks Club, Kiwanis Club, and Shriners, can provide assistance with medical supplies or help with fund-raising for medical expenses. However, local chapters offer different kinds of help, so you should look up your local chapter and contact it directly or check with your local Health and Human Services office for more information.

    Government programs
    Health care was one of the hottest topics in the 2008 and 2012 Presidential elections, and it remains to be seen how the implementation of the Affordable Care Act will change our health-care system. At this time, most Americans rely on employer-sponsored health insurance or purchase private policies. However, there are a number of government-sponsored programs that can benefit people with diabetes.

    Medicare is a government health insurance program for people ages 65 and over as well as younger people with serious health problems such as kidney failure. Part A of Medicare covers hospital stays and is provided at no cost to those who qualify. Part B covers doctor visits outside of hospitals and requires paying a monthly premium. Medicare Advantage Plans, also called Part C, are health insurance plans that are approved by Medicare but run by private companies. They are available to anyone enrolled in Parts A and B. These plans tend to offer more benefits at a greater cost; details vary from state to state.

    Parts A, B, and C now cover blood glucose meters, test strips, lancets, insulin pumps and supplies, therapeutic shoes, glaucoma screenings, flu and pneumonia vaccines, and counseling by registered dietitians and certified diabetes educators under certain conditions. Part D provides prescription drug benefits. This program is run by private insurance companies, so the cost and benefits of plans vary. However, all Part D plans “leave a huge ‘doughnut hole’ that requires patients to pay several thousand dollars a year,” says Dr. Richard Grant, an endocrinologist at Massachusetts General Hospital and author of a 2006 study published in Diabetes Care, which reported that nearly 15% of people with diabetes say they have trouble affording their prescriptions. “The trend we reported on in the study has certainly continued to worsen. With the tumbling economy, joblessness, home foreclosures, etc., people are under severe financial pressures.” Because of this gap in drug coverage, some people on Medicare will still need to find help from other sources (such as the nonprofits listed above) to help pay for their diabetes supplies or drugs.

    For Medicare eligibility information, call the Centers for Medicare & Medicaid Services at (800) 633-4227, or visit www.medicare.gov. People who have Medicare for a disability and are still struggling to make their co-payments on prescriptions may be eligible for extra benefits through Social Security, which can be applied for at www.socialsecurity.gov or by calling (800) 772-1213.

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    Statements and opinions expressed on this Web site are those of the authors and not necessarily those of the publishers or advertisers. The information provided on this Web site should not be construed as medical instruction. Consult appropriate health-care professionals before taking action based on this information.

     

     

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