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.
https://www.ssa.gov/benefits/medicare/prescriptionhelp/
ADVERTISEMENT
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.
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).
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 ssa.gov 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.