How to Pay for Diabetes Medication and Care

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According to the latest findings by the Centers for Disease Control (CDC), roughly 10% of Americans have been diagnosed with Type 1 and Type 2 diabetes. Another third of the population is in the pre-diabetes phase. When you add the numbers up, over 122 million Americans are affected by (or in danger of getting) the disease. The CDC report is based on the two types of diabetes, which are different, yet increasing similarly in the population.

When you look closer at the numbers, the data points to a more detailed picture of the ethnic groups in which diabetes is most prevalent.

• American Indians/Alaska Natives: 14.7% 
• People of Hispanic origin 12.5%
• Non-Hispanic blacks 11.7%

Regardless of ethnic group, diabetes can be controlled through treatment and medication. The problem is, it’s expensive. The same CDC report found that a person’s excess medical costs climbed from $8,417 to $9,601 over five years. Breaking down the findings by race/ethnicity is significant because the most prevalent groups tend to be the most socio-economically disadvantaged, requiring the most help paying for diabetes treatment. 

COVID-19 adds further complications. Many Americans are unemployed. And Individuals who have diabetes are considered “at increased risk for severe illness” from the coronavirus – and may not be able to receive essential treatment, suffering disruptions or delays in the deliveries of prescription drugs and insulin. Anyone in need of financial assistance and resources during this challenging, uncertain time should read on.

Average cost of treatment and care

As mentioned, managing diabetes is expensive. Dr. Giuseppe Aragona, general practitioner at Prescription Doctor, says diabetes medication costs between $25 and $200. For example, Insulin is an important component for many people with diabetes — but its price has risen 47% from 2013 to 2019. 

Add recommended doctor’s visits every three to four months, and the cost of managing and treating diabetes can cost $1,000 per month or more. Here’s a closer look at the cost of diabetes treatment and care for individuals without healthcare coverage:

Many people don’t have the money needed to control the effects of the disease. One in four diagnosed with diabetes can’t pay for insulin. But putting off needed medication or treatment can be dangerous. “If type 2 diabetes is left untreated, high blood sugar can cause bigger medical complications such as kidney damage or an increased risk for heart disease or stroke,” says Dr. Aragona.

There are options if you or someone you love is struggling to pay for the vital treatments and care required. 

Payment options available

You can’t afford to ignore your diabetes. One of the first steps to getting the diabetes treatment and care you need — even if you can’t afford it — is to consider what payment options are available. 

Insurance vs. non-insurance

Health insurance can make all the difference in the world when it comes to how much your diabetes treatment will cost. The figures in the table and graphic above are for individuals without insurance who are paying in cash. Depending on the quality of your health insurance, you may only have a small co-payment you’re responsible for, potentially saving you hundreds to thousands of dollars per month in medical and prescription drug costs.

Medicare

Medicare steps in to provide coverage for those who qualify for the program. This program is available if you’re 65 or older or have been diagnosed with a disability. It will cover diabetes testing/screening and supplies through Part B and prescription drugs through Part D. 

Pros: 

• Comprehensive diabetes coverage
• Pays for diabetes supplies

Cons: 

• Only available if you’re 65 or older or if you have a disability
• You’ll need Medicare Part B and Part D for full coverage

Medicaid

If you can’t afford health insurance and don’t meet the age or disability requirements for Medicare, your next possibility may be Medicaid. The state-funded program provides medical coverage for low-income individuals and families. Medicaid pays for screening, treatment, medication and care, as well as providing a diabetes-prevention program.

Pros: 

• Covers low-income youth and families
• Offers diabetes-prevention programs

Cons: 

• Some people can’t afford diabetes treatment but don’t qualify because they make more than the state’s low-income mandates

Loans

A personal loan may be a good choice if you need to purchase diabetes equipment or you have mounting medical bills. Finding an affordable loan with repayment terms that work with your budget can help you take the pressure off of the bills — and calls from medical debt collectors. 

Pros: 

• Good for consolidating debt
• The interest rate may be lower than late fees and finance charges

Cons: 

• Getting into debt when you can’t afford medication may not be the best decision
• Some personal loan companies charge extremely high interest

Credit cards

A credit card can be a lifesaver when you’re short on cash until your next paycheck. The key is spending and managing a credit card responsibly. The trouble is, many charge their diabetes supplies onto their credit card without paying the balance on time. Carrying a balance on a credit card can end up costing you far more in the long run than the diabetes medication you couldn’t afford. 

Pros: 

• A fast backup to cover your diabetes bills
• Flexibility to pay the balance in full or pay in installments over time

Cons: 

• High interest charges and late fees could hurt your chances of paying off the balance
• Your credit score could be affected if you don’t pay your card bill on time

Flexible Spending Account (FSA) and Health Savings Account (HSA)

If you have high-deductible health insurance, an FSA or HSA allows you to set aside cash to cover the deductible, as well as other medical expenses your insurance wants you to pay out-of-pocket for. Besides medication and doctor’s visits, your diabetes supplies are covered by an FSA/HSA plan.

Pros: 

• Many expenses related to diabetes are covered
• Contributions are tax-free 

Cons: 

• May not be enough if you anticipate higher medical bills in the future

Financial resources and assistance programs

Even with health insurance coverage and payment options, you may still find you can’t afford the out-of-pocket costs of diabetes. Fortunately, there are programs available to help you fund the care you need, all of which cover both Type 1 and Type 2 diabetes.

Tips for lowering your costs

• Speak with the drug manufacturer about discounts: Many drug manufacturers have programs for patients who can’t afford their medications. Refer to the list above for some of the larger manufacturers. Novo Nordisk, Lilly and Abbott are pharmaceutical companies providing support.
• Talk with your healthcare provider: Your doctor or healthcare facility may have financing or discount offers available. Dr. Aragona also recommends speaking with your doctor about whether generic drugs may be a good, affordable alternative. “They are usually the same medication packaged differently, so there should be very little change to the quality.”
• Sign up for a clinical trial program: A clinical trial allows patients to test out a new drug or treatment program in a carefully monitored environment. By the time a drug reaches the trial phase, it’s likely safe. You may benefit from the free treatment and have the support of the drug company’s medical team to monitor your progress. The American Diabetes Association is a partner in six current diabetes trials.
• Look for coupon and savings card programs: Some manufacturers and third-party websites such as FreeDrugCard offer coupons or savings cards that discount your drug purchases. Others include:
  • Apidra
  • Gvoke
  • JANUMET
  • JANUVIA
  • Jardiance
  • Lantus
  • Novo Nordisk and Novocare
  • Trulicity
  • Victoza

Diabetes advocacy and support groups 

People living with diabetes and their caretakers typically need more than financial support. There are advocacy support groups available to help those diagnosed with diabetes build relationships with others in a similar situation, as well as programs for learning how to live with and manage the condition. 

Many support and advocacy groups are local — check for any in your area by contacting your local hospital, medical center or by speaking with your healthcare practitioner.

The bottom line

Diabetes in the U.S. is a growing diagnosis. It’s possible to live a full life with diabetes, but the medication and treatments can be expensive. Ignoring diabetes will only lead to further complications, so addressing the problem and finding ways to pay for treatment is vital.

There are several ways to get financial support to manage the condition. Health insurance coverage should be your first stop. If you can’t afford insurance or you still have high expenses, even with coverage, there are programs and resources available for diabetes sufferers to help you pay for treatment and medication. 

We welcome your feedback on this article. Contact us at inquiries@thesimpledollar.com with comments or questions.

Image Credit: Pixels Effect/Getty Images