Some diabetes medicines are now generic and cost as little as $3 or $4 a month, or may be free through some insurers. Other, newer ones cost $100 or more a month, and insured patients often pay half that cost in co-pays. Glucose meters are often given away by companies, but the testing strips used with them can cost $1 each.
Insulin costs vary and can run to more than $200 a month for people without insurance and $20 to $40 a month in co-pays for those who do have coverage.
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"We see patients every day, with and without insurance, who can't afford the co-pays or cost for their supplies," says Carolyn Robertson, head of special projects at the Gonda Diabetes Center at UCLA Medical Center.
"Our concern is that a decision to skip a test in order to cut down the costs of strips, or to forgo a scheduled medicine, can turn a controllable disease into a crisis."
A recent survey by the Center for Studying Health System Change, a nonpartisan research group based in Washington, D.C., found that three in 10 Americans with chronic conditions, including diabetes, have trouble paying their treatment costs.
Even people with insurance will usually have some out-of-pocket expenses for their diabetes care, but there are ways to hold down costs.
Insurance: Some plans have savings and incentives programs for people with diabetes. UnitedHealthcare, for example, offers some supplies and drugs for free, as well as lower co-pays for some covered doctor visits to patients who follow a recommended diabetes plan. (The plan generally includes regular blood sugar checks, routine exams, certain screenings and scheduled online or phone sessions with a UnitedHealthcare wellness coach.)
Free Samples: Companies typically hand out free supplies, such as glucose meters and test strips, at health fairs, says Jill Lubarsky, a spokesman with the Juvenile Diabetes Research Foundation. There's no centralized listing of these events, but look for them especially in November, which is American Diabetes Month. Find fairs sponsored by the American Diabetes Assn. at diabetes.org/adm. Find diabetes expos at diabetes.org/expo.
If you've been using the same glucose meter for a while, Robertson says, you may be surprised by high-tech improvements on new devices, such as far more memory for storing readings. But find out the cost of the test strips before switching, Robertson adds. You may be trading in a perfectly fine meter for one that can cost you hundreds of dollars more per year for the strips.
Drugs: As they do for other diseases, some drug companies offer pharmaceutical assistance programs for people with diabetes. Typically, the offers are for people with no or little insurance coverage. Check if you and your drugs qualify with the Partnership for Prescription Assistance, www.pparx.org, (888) 477-2669.
Prescription cards: Major pharmaceutical companies, many of which manufacture diabetes drugs, have created the Together Rx Access Card, which offers 25% to 40% off brand-name prescription medications. To be eligible, you must have a household income of less than $30,000 for a single person or $60,000 for a family of four and be a legal resident of the U.S. (More at www.togetherrxaccess.com  444-4106.) Pharmacists may also have discount coupons for specific drugs. And you can find many at couponpages.com.
Drugstore programs: Some national drugstore and pharmacy chains have prescription programs to help customers save money on certain diabetes medications and supplies. ( Rite Aid, for example, recently offered $25 off one box of a particular brand of test strips for some consumers with diabetes.) Stores include Costco, CVS, Kmart, Rite Aid, Target and Walmart. Pharmacists, rather than store clerks, are likely to be most knowledgeable about offers.
Further information: The National Institute of Diabetes and Digestive and Kidney Diseases has a publication on financial help for people with diabetes. Go to diabetes.niddk.nih.gov and type "financial help for diabetes care" into the search box. Resources include health insurance suggestions and how to get a free device to check for foot sores -- a frequent problem for diabetics that can lead to complications such as infections and amputations if left unchecked.
Uninsured: If you've lost your insurance and stopped seeing the doctor, Robertson advises contacting a community health center for a diabetes checkup. Find clinics at www.ccalac.org (click "find a clinic" on the left side of the home page). Also ask about free supplies at community centers: Companies sometimes make donations.
Live well: Follow your non-medical regimen as well as your medical one, Robertson says. Losing weight and exercise can reduce the number of times you need to test (and thus the number of strips you'll use) and even the amount of medication you have to take. But don't reduce your meds or testing regimen without an OK from a healthcare professional.