Any suggestions on how to pay for my daughters medicine?

By Ginlea Latest Reply 2009-12-02 21:46:02 -0600
Started 2009-01-11 13:53:48 -0600

My 8 year old daughter is a Type 1 diabetic.She was diagnosed in Sept.2008.This year is a new year and we just started to figure out our budget.The problem is our insurance.
My insurance mandatory me to do the mail order for her insulin.And the mail order is $2700.00 for 3 month supply and thats not counting the syringes,stips,etc.that I have to buy.And my insurance pays up to $4200.00 and then I have to pay the next $4200. out of my pocket before the insurance kicks back in and pays 80% up to $4200. and then it goes back to paying 100%.So right now I get her medicine and supplies free untill we reach $4200. and that will not be long.Then I have to pay the next $4200. out of my pocket.That's $900. a month I have to pay and we do not have it.We are broke now paying our bills and keeping healthy food in the house,gas in our car.And I can not get any financial help because we make to much money but all our money goes to bills (rent,groceries,electric,gas,phone,)As of Jan.1 2009-today the insurance company has paid $3200.00 that means they have $1000.00 left they will pay .Then I start paying out of my pocket and that will be $900.00 + more a month coming out of me until I reach $4200. and then the insurance will pay 80%.
She needs her medicine to survive but how I am going to come up with a extra $900.00 a month.And finding a another job right now so I can work 2 jobs is out of the question with no one hiring and laying people off.I went to social services years ago to get assistance when me and my husband seperated and theyld not help me because I made to much money and now i make more then I did then but still not enough to pay for everything.Me and my husband are back together but with both ou incomes we do not have the money.I am going to try and apply for medicaid for just her and see if we can get it now since her condition is considered chronic disease.But with everyone applying for assistance right now because of the loss of jobs it might be a while before I hear anything.So What am I to do?

28 replies

US331242 2009-10-05 16:36:47 -0500 Report

I don't know your income but most of the manufacturers have patient assistance programs.

I'm a displaced worker, single and no kids. There are a million programs for kids but nothing for an average middle aged adult without kids. I did find some programs to get my insulin, needles and testing supplies for around $250 for 90 day supply. This was at WalMart/SAMS club.

imsuzie2 2009-10-06 02:23:33 -0500 Report

Have you tried to contact the insulin maker, meter manufacturer, etc to see if they offer assistance? I now take Actos, and the manufacturer mails back a check for my co-pay. Got the first rebate coupon in a magazine. My doctor also had them, and now the manufacturer will send a new rebate form with each check. Good luck. S2

US331242 2009-10-06 12:53:22 -0500 Report

I had a great 6 figure income in 2008 and all the manufacturer programs that I've looked at (about 20 so far) will only look at your tax return for the previous year. I've been displaced for 12 months now and that doesn't count, to them. Sure wish these decision makers could wear my shoes for a month! Anyhow I'm happy that WalMart/Sams was able to cut my costs by 90%.

I feel this person's pain and hope that she looks into the programs available for children. Ginlea, if you need assistance in finding something, let me know!

Vicrgreen 2009-09-05 07:13:34 -0500 Report

I don't know your income level but there is the SCHIP program (State Child Health Insurance Program) it is a Federal program administered through the state. It covers kids whose parents make to much to qualify for Medicaid but less than $50,000/year. I'd think you'd go through your state's Welfare office to get it. In Alaska it is called Denali Kid Care, what it is called where you are is anyone's guess, but I'd sure call the Welfare people and ask if you meet the guideline.

imsuzie2 2009-09-07 05:52:13 -0500 Report

Try typing "help pay for medications" in your search engine. I saw lots of sites…maybe one of them can help. Good luck. S2

dawn kelly
dawn kelly 2009-09-24 16:39:54 -0500 Report

you might be able to get your dr to give you samples of the insulins mine does this for me when needed and i cant buy all of my supplies that helps with some of the costs and you can also try to apply for programs run by the drug companies contact them direct or your dr may have more of the info and good luck

dawn kelly
dawn kelly 2009-09-24 16:40:07 -0500 Report

you might be able to get your dr to give you samples of the insulins mine does this for me when needed and i cant buy all of my supplies that helps with some of the costs and you can also try to apply for programs run by the drug companies contact them direct or your dr may have more of the info and good luck

MeiMei 2009-01-13 13:27:15 -0600 Report

I can't add any more suggestions they all are good ones. Apply for medicaid, check with the county health dept., and check and see if your doctor has samples to fill in the gaps. The samples really helped me out when I was in a bind. Be sure to check the exp dates on the samples, some of the clinics don't, and be sure to check the name of the drug, I was once given samples for something I was not taking. Good thing for me I am a nurse-practitioner.

MeiMei 2009-01-13 13:29:35 -0600 Report

Also when you are about to reach the limit order 90-120 day supplies to cover you through the gap. That suggestion was made by a pharmacist.

mike67 2009-01-12 23:47:48 -0600 Report

RX ASSIST will have patient assistance forms for most of her meds. Won't cover needles or strips etc. but will cover medication. Just type name of medication and form will appear click on it and print it. The doctor will have to sign part of it and you will have to send copy of tax return but this may help you. I am a friend of mikes and a social worker.

dj7110 2009-01-12 22:44:45 -0600 Report

I had a discusion I posted on dec 18th. I had similar problems on medicare insurance. am on same insulins as your daughter. told me there is nothing can be done about the gap in insurance.. there was a comment on it about extra help that i aplied for this yr and hopeing it helps meout this yr. I'll see when the gap hits me.. although I don't recomend it last yr I reused needles, cut all meds except inssulin and didn't take it as often as I was supose to till I made it threw the gap.. trying to save as much money as i can and going to try and do better with it this yr.. I think this is very stupid what the insurance companies are doing to try n save a buck. Maybe after enough people suffer enough to this practice of theirs they can be sued for the damages they are causeing and realize they aren't saving anything, than they would change this form of policy.

MeiMei 2009-01-13 13:23:09 -0600 Report

A suggestion made to me to cover the medicare gap is to order 90-120 day supplies when you think you are about to get to that point. I also asked for samples from my doctor—at the time Scripps Medical Clinic which was more than happy to fill in the gap. Here in Missouri, I don't think the doctors know about samples.

2009-01-12 04:37:09 -0600 Report

I had just posted a few websites for free supplies on a newcomers site looking for supplies, search discussions or go through the latest posts. I did this about 4pm Sunday. Hope this helps Claudia

G Thomas
G Thomas 2009-01-11 23:26:29 -0600 Report

No IT WONT. Take her to the health dept. also. And apply for medicaid/medicare online at the foodstamp site will come up and stroll until you see what you want. And check the insurance site here. Amy is a walking bill board for us. Take your time and comb this site. This site is a wonderful source for info. Good luck and I will look into a few things alos.

seawolf1944 2009-01-12 04:34:48 -0600 Report

Hello Jinleah,Just read about your situation. Apply for medicade just for her. While,You waitfor an answer,go to your state health department,lay out the facts, They should have a slideing pay scale based on your income. also contact your state represetative in your state government,explain your situation. Maybe,they can find some help for you. I personally think that each state should have an emergency medicine safety net in place to assist people with these need. Voters in each state should make sure,Its mandatory. I hopt things improve for you. You and your family are in my prayers.John

2catty 2009-01-11 21:47:18 -0600 Report

I don't know what state you live in, but in Tn and Ga they have a program for kids. If you can't get medicaid or TNCare and are kind of financially in between you can get tn kids care or peach care. The state you live in may be able to offer a in between insurance for your child. It doesn't cost much at all for these

Avera 2009-01-11 21:41:51 -0600 Report

I could do a search to find some place that might help near you if I could find out the city and state where you live. I also need to know what type of insulin that your daughter uses.

Without using your insurance, you can buy insulin online from Canada, but I can't even answer that question without knowing what kind she uses.

Let me know and I will see if I can find you some information.


Ginlea 2009-01-12 05:56:48 -0600 Report

I live in Yellow Springs,West virginia.Her insulin is Humalog (100u/ml) and Lantus.
See if you can find anything out and email me at small

Avera 2009-01-12 22:04:07 -0600 Report

Hello Again,

I just sent you an email on my findings. I also made copies for you in the email of everyone's answers under this post. All the people had good ideas.

Ginlea 2009-01-13 16:36:49 -0600 Report

There is no free clinics in my area. closest place that could help me is 5 hours away.I asked my doctors,the free clinics and the pharmacist,and the hospitals in my area if there is any help I can get i explained to them my situation and they did not know anything to help me.They told me to call theis one place in Va. and i did but that place only helps people who live in Va.And since I am a West Va. resident no out of state can help me.I will check out the info. you sent me but i dont understand why the doctor did not tell me I could go to other places online like Canada ang get my vials of medicine cheaper and that you do not need a perscription to get this.

GabbyPA 2009-01-11 21:14:41 -0600 Report

Geeze, I wish I had answers for these kinds of discussions. They kill me. It is such a helpless feeling it just makes you want to cry.
I have had several people tell me to ask the doctor for free samples to get you thru some of the rough parts. It is all a huge adjustment, especially when it is new to your life and budget.
There might also be some county programs for your perscriptions that could help. Talk to your pharmacist, they would know.
I know how you feel, though I am only dealing with myself and not a child. That is what makes it heartbreaking.
I would also write to your congressman/woman. Don't get real whiney, but lay out the facts. Tell them what you need and ask them if they can help you locate the help that you need.

Paula - 14421
Paula - 14421 2009-01-11 21:29:49 -0600 Report

Go to your doctor and ask them if they can call the company where this medicine comes from. Sometimes if its a hardship case the company will give you the stuff free, Can't hurt to ask let me know how it goes.


Paula - 14421
Paula - 14421 2009-01-11 21:31:54 -0600 Report

Or even ask your pharmacist the same question sometimes they have more answers than your doctor.


LadyDi - 26259Miller
LadyDi - 26259Miller 2009-01-11 21:35:22 -0600 Report

I was just going to suggest both of those options. It's worth a try. Check with the local hospitals or the local health department. Go on the manufacturer's website to see if they have a special program that you might take advantage of.

Splenda 2009-12-02 21:46:02 -0600 Report

This is true…Befor I got on Medicare I got my meds free from the drug companys. Your doc orders them and you pick them up at the doc office. You have to show proof of income. My doctor has one nurse that does this all the time…its her job. If my niece were not a nurse I would never have known. Good luck and God bless.

caragypsy 2009-01-11 21:00:54 -0600 Report

There are a lot of discussions about this problem on this site. just go to SEARCH DISCUSSIONS and look for things to read.