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Diabetes Costs: Paying for the Insulin Pump continued...
But after all that, "We have never really had a problem with insurance once we've approved somebody to be on a pump."
Thirty-two state governments now have programs to help people who don't qualify for Medicaid coverage of prescription drugs. The income caps vary widely, from $35,000 a year for singles in New York to $17,000 a year for singles in Missouri. Most programs are for seniors and Medicare beneficiaries, though a few, like Maine's drug discount, have no age limit.
How these state programs will mesh with the new Medicare prescription drug benefits, set to take effect in 2006, has not been ironed out yet, says Juliette Cubanski, a senior policy analyst at the Kaiser Family Foundation.
Currently, 29 states also have "high-risk pools" that provide insurance to people whose existing illnesses make buying a private health plan too expensive.
Assistance from drug companies is another possibility for those who are too young to benefit from programs geared toward seniors.
Pfizer runs a discount program called "Pfizer Pfriends," which is open to anyone without drug coverage. GlaxoSmithKline's "Bridges to Access" program hands out free medication to people who qualify. The income cap is $25,000 a year for singles, or 250% of the federal poverty limit for families, and the enrollment process has to be handled by a third party.
You can search for these and other discounts at Partners for Prescription Assistance, www.pparx.org, a web site set up by drug companies, insurers, and patient advocacy groups to help people find discounts available to them.
"The programs are worth exploring," Cubanski tells WebMD. "They're good for people who are taking drugs that are made by these companies, who don't have any other source of drug coverage."
A drawback to these kinds of programs, she says, is that only brand-name drugs are involved. "If the potential exists for a consumer to switch from a brand name drug to a generic drug, they might not necessarily get that information," Cubanski says.