Prescription medications for diabetes have been in the news a lot lately. Pharmaceutical companies are coming under fire for charging people so much for insulin and other life-saving drugs but nothing is really done about it. Healthcare is becoming a complicated political mess and prices continue to rise.
Who can you turn to if you can’t afford your diabetic medication?
You may not be familiar with the pharmaceutical company Lilly but, if you have diabetes, you are probably familiar with some of their medications:
Glucagon 1mg injection
Humalog 50/50 vials
Humalog 75/25 vials
Humalog Kwikpen 50/50
Humalog Kwikpen 75/25
Humalog U-100 Kwikpen 3mL
Humalog U-100 Vials
Humalog U-200 3ml Kwikpen
Humulin 70/30 Pens
Humulin 70/30 vials
Humulin N Kwikpen
Humulin N vials
Humulin R U-100 vials
Humulin R U-500 Kwikpen
Humulin R U500 to be used with U500 syringes
Lilly can provide these diabetes medications for free through their patient assistance program Lilly Cares. In this article, we’ll give you the information you need to apply for Humalog, Humulin, or Glucagon (or most of the other medications on the program) through Lilly Cares.
DO YOU QUALIFY?
The first step is figuring out if you qualify for the Lilly Cares program. In order to qualify, you must be an uninsured American over the age of 18 and you cannot be eligible for Medicaid or VA Benefits.
If you are eligible for Medicare Part D, you must be enrolled in a Medicare Part D plan and you must have already spent $1,100 on prescriptions in this calendar year. Be sure to include a copy of the front of your Medicare Part D card with your application.
Medicare Part D patients who make less than $1,356.75 a month (for a single person) or $1,827 a month (for two person household), will also have to apply for the Low Income Subsidy, also called Extra Help. This program is offered by Social Security and is designed to provide extra help with Medicare costs. You can apply here: https://www.ssa.gov/medicare/prescriptionhelp/
If you qualify for the Extra Help program, you will not be eligible for the Lilly Cares program but your medications should be covered by the Extra Help. If you are denied assistance by the Extra Help program, send your denial letter to Lilly Cares to prove that you have no other means of prescription coverage.
PROOF OF INCOME
Regardless of your prescription coverage, every adult who lives within your home has to provide Proof of Income to verify that your gross household income is below 300% of the Federal Poverty Level.
This proof of income could include current pay stubs, last year’s income tax, an Unemployment Benefit Statement, Social Security Income Yearly Benefit Statement, or a W-2 or 1099. If you can’t find your benefit statements, Lilly will accept bank statements that show the deposit of funds.
Lilly Cares will require Medicaid Denial Letter if you have zero income. You will also need a Medicaid Denial Letter if your household is under 137% of the Federal Poverty Level and you live in the following states:
Under these particular circumstances, it’s possible that Lilly Cares will provide you with one gratis shipment and a temporary enrollment in their patient assistance program while you apply for, and get denied by, Medicaid.
You can find the Lilly Cares application here: http://www.lillycares.com/_Assets/pdf/2017PAPApplication.pdf
Be sure to read the additional instructions on the form just in case anything in their program has changed unexpectedly.
When you have gathered your household’s proof of income and filled out the patient information on the Lilly Cares application, your physician needs to fill out his/her portion of the application. Make sure that you both fill out the entire application as neatly as possible. If you or your doctor make a mistake on the form, you can use white-out to correct it.
In most cases, it should be unnecessary for you to make an an appointment with your doctor to get your paperwork filled out but it’s best to call them to find out their policy for filling out patient assistance forms.
When you’ve completed the paperwork, you can either fax it or mail it to Lilly Cares.
Lilly Cares Foundation Patient Assistance Program
PO Box 13185
La Jolla, CA 92039
Fax: (844) 431-6650
The prescription (which is embedded in the enrollment form) has to be filled out to the Lilly Cares program specifications which can vary by medication.
Humulin and Humalog can be refilled every 120 days but your doctor is only required to list the name of the medication and the daily directions for use on the prescription. Glucagon, on the other hand, must be refilled every 30 days and so the prescription should specify “1 kit per 30 day supply.” If you or your doctor have any questions about how the prescription or the application should be filled out, call the Lilly Cares program at: 1-800-545-6962.
Even if you don’t have questions, please take time to go over your forms and proof of income very carefully before sending it off. It’s better to have a phone conversation now than to deal with a mistake on the prescription later. It will take Lilly Cares a minimum of 4-6 weeks to process your paperwork under the best conditions and mistakes could lead to longer processing times or even denial.
Once you’ve been approved by the Lilly Cares program, your medication can only be shipped to your doctor’s office. Your enrollment will last 1 year no matter what medication you take, as long as you are not on Medicare Part D. If you do have Medicare Part D, your enrollment will only last for one calendar year and end in December.
Be sure to keep in close contact with your doctor’s office to avoid any mixups or lapses. Because of the long processing times, your doctor or advocate can request refills about 30 days in advance via a fax refill form. For example, Humalog and Humulin are shipped in 120 day supplies so they should be requested every 90 days to avoid a lapse in medication.
After your enrollment runs out, Lilly Cares will send re-enrollment information to you and your doctor. Be sure and check over any and all information they send you because the program or the application might have changed. Re-enroll as soon as you possibly can to avoid lapses in your medication.
Diabetic medications can be expensive, especially when you are on a fixed income. It seems unfair that something so necessary should be so difficult to afford. Luckily, there are Patient Assistance Programs out there for those who qualify.
If you are struggling to afford the medication you need to control your diabetes, please look into Lilly Cares or other patient assistance programs. Your health is your most important asset.
If you are looking at all these instructions and feeling overwhelmed by the process for enrolling in the Lilly Cares patient assistance program, you might be relieved to hear that you don’t have to go it alone! There are prescription and Medicare advocates at Prescription Lifeline just waiting to help you.
Prescription Lifeline has 15 years of experience dealing with patient assistance programs and Medicare. They have an army of advocates and special software created to make helping people faster, easier, and more accurate than ever.
If you need help getting enrolled in the Lilly Cares Program, Prescription Lifeline can assist you! Contact Prescription Lifeline at www.PrescriptionLifeline.org or call and speak to a patient advocate at 1-888-331-1002. Whether you need help with prescriptions or you’re just curious about getting the best price for your Medicare coverage, Prescription Lifeline is here to help.