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Ways to save on your diabetes medication

We understand how overwhelming it can be to manage a condition like diabetes, not to mention covering the cost of medication. If you are concerned about paying for your medication, or the medication of a family member, there are resources available to ease the burden.

Start by choosing the type of insurance coverage that you have below. If you do not have insurance, or your medication is not covered by your insurance, choose "no insurance."

Medicare Part D

  1. Aging and Disability Resource Center: The ADRC has a benefits specialist and social workers available to help you navigate medication coverage questions and concerns regarding ability to pay. If you live in Minnesota or Iowa, call (608) 785-5700 and ADRC staff will direct you to the resources available in your area.
    • ADRC of Adams County: (877) 883-5378
    • ADRC of Buffalo County: (866) 578-2372
    • ADRC of Crawford County: (608) 326-0235
    • ADRC of Grant County: (608) 723-6113
    • ADRC of Jackson County: (715) 284-3978 or (844) 493-4245
    • ADRC of Juneau County: (877) 794-2372
    • ADRC of La Crosse County: (608) 785-5700 or (800) 500-3910
    • ADRC of Monroe County: (608) 269-8690 or (888) 339-7854
    • ADRC of Trempealeau County: (800) 273-2001
    • ADRC of Vernon County: 608-637-5201 or (888) 637-1323
  2. Manufacturer's Pharmaceutical Assistance Programs (PAPs): This is not a copay card, but these are medications shipped from the manufacturer to you with the exception of insulin. (Insulin is shipped to Gundersen due to storage requirements, where it is available for pick up.) This is typically income-related. You can also go to the manufacturer's website or NeedyMeds.
  3. A Gundersen social worker can do a price check if you know the medication and dose.
  4. Drug Repository program: Participating pharmacies (including Gundersen Health System East Pharmacy) can accept donated, unused, sealed medications from patients. These medications can then be dispensed by a pharmacist to other patients for a minimal charge. If you need a medication from this program, your prescription must state, "ok to use repository supply." If the medication is available, you can obtain it by signing a waiver and paying a small fee (usually $5) to the pharmacy.
  5. Medicare program Extra Help: This Medicare program helps people with limited income and resources pay Medicare prescription drug program costs, like premiums, deductibles and coinsurance. For more information, call (800) 772-1213. TTY users can call (800) 325-0778. You may apply in person at the local Social Security office. You must provide the following to apply for Extra Help: Information about your resources and income (and your spouse's resources and income, if married or living together), such as statements that show account balances at banks, credit unions or other financial institutions, investment statements, stock certificates, tax returns, pension award letters and payroll slips. You may qualify for other subsidy programs by completing Extra Help application.
  6. State Pharmaceutical Assistance Programs (SPAPs): Many states and the U.S. Virgin Islands offer help paying drug plan premiums and/or other drug costs.
  7. Walmart ReliOn Insulin is available for $25 per vial (70/30, Regular and NPH).
  8. RxOutreach: Provides prescription drugs to people who are uninsured and to people who have limited prescription drug coverage. It is a fully-licensed mail order pharmacy offering lower prices for over 400 medications. Prescriptions are mailed to homes. There is an income limit to qualify.
  9. Medicare Part D: Coverage Stages (2018 information; Resets every year)
    • Deductible (Stage 1):
      • You pay 100% of drug cost until the deductible is met
      • Not all plans have a deductible
      • Deductible may not apply to all tiers (i.e. some plans exempt Tiers 1 & 2 from deductible)
    • Initial Coverage (Stage 2):
      • Both youand the plan pay medication costs until the shared total equals $3,750
      • Standard copays and coinsurance apply during this phase
    • Coverage Gap ("Donut Hole," Stage 3):
      • Begins after you and plan have spent $3,750 for covered drugs
      • Ends when you have spent $5,000 for the covered drugs
      • While in this phase, you pay 35% of the cost of brand drugs, and 44% of the cost of generic drugs
      • The medication deductible, copays and coinsurance that you paid in Stages 1 and 2 count toward the $5,000 limit
      • For brand drugs, the drug manufacturer pays 50% of the total drug cost, and this does count toward the $5,000 limit
      • The amount the plan paid in Stage 2 does not count toward the $5,000 limit
    • Catastrophic Coverage (Stage 4):
      • Catastrophic coverage begins when you reach the $5,000 limit.
      • While in this phase, you pay $8.35 for brand drugs or $3.35 for generic drugs, or 5% of your medication’s cost, whichever is greater.

Medicare with No Drug Coverage

  1. Aging and Disability Resource Center: The ADRC has a benefits specialist and social workers available to help you navigate medication coverage questions and concerns regarding ability to pay. If you live in Minnesota or Iowa, call (608) 785-5700 and ADRC staff will direct you to the resources available in your area.
    • ADRC of Adams County: (877) 883-5378
    • ADRC of Buffalo County: (866) 578-2372
    • ADRC of Crawford County: (608) 326-0235
    • ADRC of Grant County: (608) 723-6113
    • ADRC of Jackson County: (715) 284-3978 or (844) 493-4245
    • ADRC of Juneau County: (877) 794-2372
    • ADRC of La Crosse County: (608) 785-5700 or (800) 500-3910
    • ADRC of Monroe County: (608) 269-8690 or (888) 339-7854
    • ADRC of Trempealeau County: (800) 273-2001
    • ADRC of Vernon County: 608-637-5201 or (888) 637-1323
  2. Gundersen Health System Clinic Pharmacy Cash Card program: Available at Gundersen Clinic Pharmacies in La Crosse or Onalaska. The most you would pay per drug (prescribed by a Gundersen provider) would be $20 per month (if total drug cost is less than$500 per month). Includes brand and generic drugs. Program is no cost to you. No income restrictions apply. Only available to patients without prescription insurance.
  3. Manufacturer's Pharmaceutical Assistance Programs (PAPs): This is not a copay card, but these are medications shipped from the manufacturer to you with the exception of insulin. (Insulin is shipped to Gundersen due to storage requirements, where it is available for pick up.) This is typically income-related. You can also go to the manufacturer's website or NeedyMeds.
  4. A Gundersen social worker can do a price check if you know the medication and dose.
  5. Drug Repository program: Participating pharmacies (including Gundersen Health System East Pharmacy) can accept donated, unused, sealed medications from patients. These medications can then be dispensed by a pharmacist to other patients for a minimal charge. If you need a medication from this program, your prescription must state, "ok to use repository supply." If the medication is available, you can obtain it by signing a waiver and paying a small fee (usually $5) to the pharmacy.
  6. State Pharmaceutical Assistance Programs (SPAPs): Many states and the U.S. Virgin Islands offer help paying drug plan premiums and/or other drug costs.
  7. Try Extra Help: This Medicare program helps people with limited income and resources pay Medicare prescription drug program costs, like premiums, deductibles and coinsurance. For more information, call (800) 772-1213. TTY users can call (800) 325-0778. You may apply in person at the local Social Security office. You must provide the following to apply for Extra Help: Information about your resources and income (and your spouse's resources and income, if married or living together), such as statements that show account balances at banks, credit unions or other financial institutions, investment statements, stock certificates, tax returns, pension award letters and payroll slips. You may qualify for other subsidy programs by completing Extra Help application.
  8. Then explore Wisconsin Senior Care: Must be a Wisconsin resident and 65 or older. Program is similar to Badger Care (same drug formulary). Income restrictions apply.
  9. Walmart ReliOn Insulin is available for $25 per vial (70/30, Regular and NPH).
  10. RxOutreach: Provides prescription drugs to people who are uninsured and to people who have limited prescription drug coverage. It is a fully-licensed mail order pharmacy offering lower prices for over 400 medications. Prescriptions are mailed to homes. There is an income limit to qualify.

Medicaid/Medical Assistance

  1. Chose the correct drug on formulary.
  2. Aging and Disability Resource Center: The ADRC has a benefits specialist and social workers available to help you navigate medication coverage questions and concerns regarding ability to pay. If you live in Minnesota or Iowa, call (608) 785-5700 and ADRC staff will direct you to the resources available in your area.
    • ADRC of Adams County: (877) 883-5378
    • ADRC of Buffalo County: (866) 578-2372
    • ADRC of Crawford County: (608) 326-0235
    • ADRC of Grant County: (608) 723-6113
    • ADRC of Jackson County: (715) 284-3978 or (844) 493-4245
    • ADRC of Juneau County: (877) 794-2372
    • ADRC of La Crosse County: (608) 785-5700 or (800) 500-3910
    • ADRC of Monroe County: (608) 269-8690 or (888) 339-7854
    • ADRC of Trempealeau County: (800) 273-2001
    • ADRC of Vernon County: 608-637-5201 or (888) 637-1323
  3. State Pharmaceutical Assistance Programs (SPAPs): Many states and the U.S. Virgin Islands offer help paying drug plan premiums and/or other drug costs.
  4. A Gundersen social worker can help if you cannot afford the copay.
  5. RxOutreach: Provides prescription drugs to people who are uninsured and to people who have limited prescription drug coverage. It is a fully-licensed mail order pharmacy offering lower prices for over 400 medications. Prescriptions are mailed to homes. There is an income limit to qualify.

No Insurance

  1. A Gundersen social worker can determine if you qualify for Medicaid, Senior Care or Health Exchanges. Social workers can also do a price check if you know the medication and dose.
    • Senior Care - Must be a Wisconsin resident and 65 or older. Program is similar to Badger Care (same drug formulary). Income restrictions apply.
  2. Aging and Disability Resource Center: The ADRC has a benefits specialist and social workers available to help you navigate medication coverage questions and concerns regarding ability to pay. If you live in Minnesota or Iowa, call (608) 785-5700 and ADRC staff will direct you to the resources available in your area.
    • ADRC of Adams County: (877) 883-5378
    • ADRC of Buffalo County: (866) 578-2372
    • ADRC of Crawford County: (608) 326-0235
    • ADRC of Grant County: (608) 723-6113
    • ADRC of Jackson County: (715) 284-3978 or (844) 493-4245
    • ADRC of Juneau County: (877) 794-2372
    • ADRC of La Crosse County: (608) 785-5700 or (800) 500-3910
    • ADRC of Monroe County: (608) 269-8690 or (888) 339-7854
    • ADRC of Trempealeau County: (800) 273-2001
    • ADRC of Vernon County: 608-637-5201 or (888) 637-1323
  3. Gundersen Health System Clinic Pharmacy Cash Card program: Available at Gundersen Clinic Pharmacies in La Crosse or Onalaska. The most you would pay per drug (prescribed by a Gundersen provider) would be $20 per month (if total drug cost is less than$500 per month). Includes brand and generic drugs. Program is no cost to you. No income restrictions apply. Only available to patients without prescription insurance.
  4. Great Rivers 211: Call 2-1-1 and they will direct you to resources that might be available.
  5. Manufacturer's Pharmaceutical Assistance Programs (PAPs): This is not a copay card, but these are medications shipped from the manufacturer to you with the exception of insulin. (Insulin is shipped to Gundersen due to storage requirements, where it is available for pick up.) This is typically income-related. You can also go to the manufacturer's website or NeedyMeds.
  6. Copay Cards. Go online or get through pharmaceutical reps. Most copay cards reduce your cost $0-$25. Google search drug name and "copay card" and find the one that links back to the manufacturer's website.
  7. Discount cards. These cards cannot be used in addition to other insurance coverage. The discount can be significant on some generic drugs; however, there is typically little discount available brand drugs. The amount of discount varies by card and by pharmacy. Pharmacy participation may vary.
  8. Walmart ReliOn Insulin is available for $25 per vial (70/30, Regular and NPH).

Commercial Insurance

  1. Copay Cards. Go online or get through pharmaceutical reps. Most copay cards reduce your cost $0-$25. Google search drug name and "copay card" and find the one that links back to the manufacturer's website.
  2. Manufacturer's Pharmaceutical Assistance Programs (PAPs): This is not a copay card, but these are medications shipped from the manufacturer to you with the exception of insulin. (Insulin is shipped to Gundersen due to storage requirements, where it is available for pick up.) This is typically income-related. You can also go to the manufacturer's website or NeedyMeds.
  3. Aging and Disability Resource Center: The ADRC has a benefits specialist and social workers available to help you navigate medication coverage questions and concerns regarding ability to pay. If you live in Minnesota or Iowa, call (608) 785-5700 and ADRC staff will direct you to the resources available in your area.
    • ADRC of Adams County: (877) 883-5378
    • ADRC of Buffalo County: (866) 578-2372
    • ADRC of Crawford County: (608) 326-0235
    • ADRC of Grant County: (608) 723-6113
    • ADRC of Jackson County: (715) 284-3978 or (844) 493-4245
    • ADRC of Juneau County: (877) 794-2372
    • ADRC of La Crosse County: (608) 785-5700 or (800) 500-3910
    • ADRC of Monroe County: (608) 269-8690 or (888) 339-7854
    • ADRC of Trempealeau County: (800) 273-2001
    • ADRC of Vernon County: 608-637-5201 or (888) 637-1323
  4. A Gundersen social worker can help, if needed.
  5. Drug Repository program: Participating pharmacies (including Gundersen Health System East Pharmacy) can accept donated, unused, sealed medications from patients. These medications can then be dispensed by a pharmacist to other patients for a minimal charge. If you need a medication from this program, your prescription must state, "ok to use repository supply." If the medication is available, you can obtain it by signing a waiver and paying a small fee (usually $5) to the pharmacy.
  6. State Pharmaceutical Assistance Programs (SPAPs): Many states and the U.S. Virgin Islands offer help paying drug plan premiums and/or other drug costs.
  7. RxOutreach: Provides prescription drugs to people who are uninsured and to people who have limited prescription drug coverage. It is a fully-licensed mail order pharmacy offering lower prices for over 400 medications. Prescriptions are mailed to homes. There is an income limit to qualify.

Additional Resources

  1. Partnership for Prescription Assistance is a website where one application can be filled out to determine your eligibility for medication assistance.
  2. Great Rivers 211 a local resource that can connect patients to community resources for medications and any other assistance.
  3. Benefits checkup
  4. RxAssist
  5. National Patient Advocate Foundation
  6. National Organization for Rare Disorders
Love + Medicine

Every day, Gundersen Health System staff deliver great medicine plus a little something extra—we call it Love + Medicine.

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