Helpful Resources for people with Diabetes

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1 Helpful Resources for people with Diabetes

2 Help with Diabetes tablets and insulin The goal of the program is to help eligible uninsured and underinsured patients of all ages receive needed prescription medications. New Hampshire Medication Bridge through ACHS (Ammonoosuc Community Health Services in Littleton) Medications are supplied at a reduced cost based on a sliding scale for patients with limited income and resources. ACHS Pharmacy Phone (603) Fax Located at: Ammonoosuc Community Health Services, Inc. 25 Mt. Eustis Road, Littleton, NH The pharmacy is open the same hours as the ACHS-Littleton care delivery site. M T W Th F S 8-6:30 8-6:30 8-6:30 8-6:30 8-6:30 9-4

3 Help with Diabetes tablets and other medications WALMART pharmacy offers many meds for only $4.00 per 30 day supply AND $10 for a 90 day supply. The link below shows all the meds available through this program in a printable format. Walmart Pharmacy 615 Meadow St. Littleton, NH Phone: (603)

4 Help with insulin for Diabetes This program is an assistance program is for patients that do not have prescription coverage and are not eligible for Medicare or Medicaid. Lantus Insulin Patient assistance program by the makers of Lantus insulin products Free medications to people who cannot afford to buy their medicine. The link below is for the Lantus Insulin Pen Printable Application Form in pdf format Patients with Medicare Part D might be considered if they are ineligible for Low Income Subsidy and have spent at least 5% of their annual household income (out of pocket) on medications. Medications will be shipped to your Doctor s office for your pick up.

5 Help with insulin for Diabetes Novolog Insulin Includes Novolog and Novolog 70/30 insulin pens and vials. A free 90 day supply to patients that do not have insurance and do not qualify for Medicare, Medicaid or Veterans programs. Exceptions include patients who have entered the coverage gap in Medicare part D (donut hole) and patients who have applied for and were denied Medicare Extra Help/Low Income Subsidy (LIS) and are Medicare eligible. Instructions on how to apply are below: (Can take 3 weeks before patient actually receives insulin) Instructions AND the application form : Cornerstone For Care Contact Info CLICK BOTH ARROWS

6 Help with insulin for Diabetes To receive free Lilly medicines through Lilly Cares, you must: Have no prescription drug coverage Be a United States resident. Meet the household income guidelines for the program. Income guidelines are noted on web link. Humalog Insulin To apply to Lilly Cares: Download an application here or request one be sent to you by calling A 120-day supply of medicine will be shipped to your health care provider's office for you to pick up. Prescription refills will be available during your 1-year enrollment period. For refills, please complete and submit the fax refill form

7 Help with insulin for Diabetes Includes these insulins: Humalog Humalog Mix75/25 Humalog Mix50/50 Humulin 70/30 Humulin N Humulin R Humulin R U-500 and also Glucagon Humalog Insulin You and your doctor must fill out and mail or fax the completed application, along with your proof of income. Keep a photocopy of your application and your original income documents. If approved, your medication will be shipped to your doctor s office. You will remain enrolled in the program for up to 1 year. To continue receiving free Lilly medicines, you must reapply each year. For additional information about Lilly Cares, call

8 Help with Diabetes tablets, Insulin and other meds Other Medication Assistance Programs Online RX Assist Provides a listing of most drug companies that have patient assistance programs and the medications they provide as well as the required applications. Search by brand name, generic name, drug class, or company. Needy Meds - Provides a listing of most drug companies that have patient assistance programs and the medications they provide.

9 Help with Diabetes tablets, Insulin and other meds Other Medication Assistance Programs Online RX Hope - RxHope is a helping hand to people in need in obtaining critical medications that they would normally have trouble affording. This website provides a medication search to medication assistance programs and provides online forms and links to apply for these programs.

10 Help with Diabetes testing supplies Free Style brand test strips and lancets Free to eligible patients without insurance coverage. The Abbott Patient Assistance Foundation provides Abbott diabetes care products at no cost to patients experiencing financial difficulties. Eligible patients typically have no healthcare coverage for the requested product and do not have access to alternative sources of coverage or funding. Application and instructions at this web link: Abbott Patient Assistance Foundation Diabetes Care PO Box 270 Somerville, NJ Phone : (800)

11 Help with Diabetes testing supplies Free Style brand test strips and lancets co-pay assistance for test strip refills for patients with insurance. This program provides patients with a reduced co-pay of $15 per refill instead of the patient s original higher co-pay. Co-pay assistance is not valid for prescriptions reimbursed under Medicare, Medicaid, or similar federal or state programs or in Massachusetts. Eligible patients are responsible for the first $15 of each co-pay under their insurance coverage; patients on high co-pay plans may have additional responsibility. Uninsured patients are also eligible in most situations. Free Style will provide patients with a new meter for free.

New patients approved for the Novo Nordisk PAP may only be eligible for insulin vials. For a full list of available products, please visit:

New patients approved for the Novo Nordisk PAP may only be eligible for insulin vials. For a full list of available products, please visit: The Novo Nordisk Diabetes Patient Assistance Program (PAP) provides medication to qualifying applicants at no charge. If the applicant qualifies under the Novo Nordisk Diabetes PAP guidelines, a 120-day

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