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Hard Times: Diabetes on a Stretched Budget

If you have diabetes, there is no getting around the fact that taking care of yourself can be expensive.  The cost of medical care, diabetes medications and supplies, and healthy foods add up. These expenses can be difficult to manage even in the best of times.  In hard times it can seem impossible.  With the current economic downturn, many people are having trouble with even the most basic diabetes expenses.  This article provides a few suggestions for managing your diabetes during the hard times.

General Financial Management
Having a budget and sticking to it is important for everyone, even more so during hard times. You should evaluate your personal or family budget at least once a year, or more often if your income or expenses are changing.  Involve the entire family in discussing the budget and brainstorming for ways to save money.

Here are a few questions to consider:

•  What is your monthly income?

•  What are your monthly expenses for essentials (home, utilities, phone, food, transportation, medicine)?

•  When are your bills due? Avoid late fees by paying bills on time. 

•  Do you have expenses that come once or twice a year (such as taxes and insurance)?

•  Where does the money go from your wallet?  Keep a diary of your spending.

•  Identify non-essential expenses (entertainment, shopping as “stress management,” soda, eating out).

Paying cash helps you stay within your limits.  Use a credit card only in emergencies.  If you have several cards, cancel most of them, and keep (one and two).  Pay off your credit card bill each month, so you aren’t paying high interest for carrying charges.  If you have credit card debt, call your creditors to discuss options to deal with it, and try to negotiate a lower interest rate.  If you feel you cannot do this, or if your debt load is overwhelming, find out if consumer credit counseling is available in your area. 

If you need financial assistance, find what help is available in your community.   In most of the U.S., dialing 2-1-1 will connect you to information about helpful resources in your community.   2-1-1 offers information on a broad range of services, such as rent assistance, food banks, affordable housing, health resources, and much more.  2-1-1 service is available in 46 states, Washington DC and Puerto Rico.  It is in development in Illinois, Pennsylvania, Arizona, and Wyoming.

If you are planning to go to an agency for financial assistance, ask what documents you need to bring with you.  Most require state-issued identification, proof of residency, and proof of income.  You’ll need to know exactly what the agency you’re working with will accept.

Getting Health Care and Medications
If you do not have health insurance, federally-funded health centers provide care in most cities and many rural areas. Charges are based on your income. Health centers provide a broad range of health care services and medications.  You can locate health centers at http://findahealthcenter.hrsa.gov/, or by dialing 2-1-1.
 
If you have insurance that covers medications, different medications are probably priced differently. They may be listed as “preferred” on your formulary, or as Tiers 1-3.  Ask your pharmacist to check if your insurance has a lower cost alternative for your medications or blood glucose meter, or if there is a difference in the cost of insulin pens, vials of insulin, and syringes. 

If you have problems affording your medication, consider Prescription Assistance Programs.  These are sponsored by pharmaceutical companies and provide free or discounted medicines to people who meet specific guidelines.  The chart labeled “Prescription Assistance Programs” lists several organizations that provide information about the programs.  Please notice that eligibility criteria are different for every program.

If you can use generic medications, several national chains offer them at low cost.  See the chart labeled “Generic Drug Programs” for information about specific chains. 

If you have no insurance coverage for medications, and other options do not work for you, you can obtain a discount drug card that will allow you to purchase certain medications at a discount.  See the chart labeled “Discount Drug Cards” for more
information.

If you have trouble affording meters, strips, or a medically necessary insulin pump, help is available for this too.  See the chart labeled “Diabetes Supplies” for more information.  In addition, many local diabetes associations offer some short-term assistance with blood glucose meters and strips.

Healthy Eating on a Budget
Many people have the misconception healthy meals are always more expensive.  Actually, healthy eating can save money through using smaller portion sizes and fewer high-calorie, high-priced foods.  
 
Here is a list of tips to help you keep your food prices down:

•  Plan a menu each week based on sales in grocery stores near you. 

•  Check what you already have to keep from buying what you do not need.

•  Take a shopping list with you, and buy only what is on that list.

•  Avoid going to the store if you are hungry, to make it easier to stick to your list. 

•  Store brand or generics are often just as good as name brand, and usually less expensive.

•  Cook enough to have leftovers.  Take the leftovers to work instead of buying lunch, or freeze the leftovers for a busy time.

•  Add fresh or frozen vegetables to casseroles, stews, or soups.  This is a good way to increase your vegetables and stretch a meal.

If you never learned to cook from scratch, learn how to make basic foods from simple ingredients.  You can cut your grocery bill a lot by avoiding pre-prepared foods and cooking from simple ingredients.  You can borrow a basic cookbook from a public library to get started.

For advice from other blind cooks, you can join NFB’s blind-cooks e-mail list.  To subscribe, go to: http://www.nfbnet.org/mailman/listinfo/blind-cooks_nfbnet.org. 

If your finances are extremely limited, find out where nearby hunger centers or food pantries are by dialing 2-1-1, or asking at a local social service agency.  In addition, some religious organizations or community centers serve meals.  Meals on Wheels can deliver hot meals if you are home bound.

If you have some money, but not enough, Angel Food Ministries might help.  This is a non-profit, non-denominational organization and provides grocery relief and financial support in 35 states.  There are no income restrictions or applications. Church host sites take orders monthly, and accept food stamps.  A box of food worth about $60 costs only $30.  One box of Angel Food helps to feed a family of four for about one week or a single senior citizen for almost a month.  Other specials such as the “fresh fruit and vegetable” box or “meat combo” can also be purchased.   Call 1-877-366-3646 or check the Web site at http://www.angelfoodministries.com/.

Just Ask!

Don’t be afraid to ask for help.  The suggestions in this article can get you started.  You should also ask your diabetes educator, a hospital or clinic social worker, local pastors, and friends and family if they know of other sources of help.  The goal is to find a way to stretch your budget and keep you healthy.

Prescription Assistance Programs

Name

Web Site

Phone Number

Description

NeedyMeds.org

www.needymeds.org

 

Provides information about assistance programs of all kinds.

Partnership for Prescription Assistance

www.pparx.org

888-477-2669

Offers a single point of access to more than 475 public and private patient assistance programs.

RxAssist

www.rxassist.org

401-729-3284

A resource center with information about all kinds of patient assistance programs.

Generic Drug Programs

Name

Cost

Other Information

CVS Pharmacy Health Savings Pass

$9.99 90-day supply of over 400 generic prescriptions

$10.00/person membership and 10% off at MinuteClinic on any regular priced health service. (Not in Florida)

K-Mart

$5.00 generic antibiotic, $10.00 and $15.00 (90-day) supply of generic drugs, $5.00-$25.00 oral contraceptive, vitamins, osteoporosis, and breast cancer prescriptions

GoldK Age 50 and over, uninsured, savings of up to 5% off diabetes prescriptions, up to 10% off brand name drugs, and up to 20% off generic drugs

Sam’s Club or Wal-Mart 

$4.00 (30-day) or $10.00 (90-day)

 

Target

$4.00 (30-day) supply of 300 generic drugs

 

Walgreens

$12.00 (90-day)

Membership: $20 individual or $35 family, 10% off Walgreen products and photofinishing

Discount Prescription Cards (Must have no prescription insurance)

Name

Web Site

Phone Number

Information

Merck Prescription Discount Card

www.merck.com

800-506-3725

15%-20% discount on medications

Pfizer, Inc.

www.pfizerhelpfulanswers.com

800-707-8990 

Savings 15-32%

Together Rx Access

www.togetherrxaccess.com

800-444-4106

Save between 25%-40% on brand name prescription medications

Diabetes Supplies

Name

Web Site

Phone Number

Description

Abbot Diabetes Care Patient Assistance Program

 

800-222-6885

Provides one meter, strips and lancets for one year. Strict eligibility guidelines.

IPump.org

www.ipump.org

 

Assists qualifying persons of any age with assistance in purchasing their first insulin pump

IPump.org - Request for Essential Diabetes Supplies (REDS)

www.ipump.org

 

Diabetes supplies for qualified patients for up to three months.

About the Authors

Connie KleinbeckConnie Kleinbeck RN, BSN, CDE is the Inpatient Diabetes Educator at Truman Medical Center in Kansas City, Missouri.  She has been a CDE since 1986.  She writes articles and speaks about diabetes and disabilities to other health care professionals as frequently as possible.  Connie wrote most of this article, and Ann added a few suggestions.

Ann S. WilliamsAnn S. Williams is an RN, with a PhD in Psychology, and has worked as a diabetes educator for 20 years.  She has specialized in teaching independent diabetes self-management for blind people and writes and speaks frequently on this topic for other health care professionals.  She was the founder and past chair of the Disabilities Specialty Practice Group of the American Association of Diabetes Educators, and remains an active member of that group.