What We Do
What We Do

Convene, Collaborate, Communicate

Our experienced and passionate advocates engage policymakers and public and private sector influencers, breaking down barriers to care for 34 million Americans with diabetes.  Learn more about DLC’s policy and advocacy initiatives. 

Diabetes Health Care Reform

Politicians keep talking about fixing the U.S. health care system. The Diabetes Leadership Council wants to show them the way. That’s why we led 12 national diabetes advocacy organizations to develop a roadmap on U.S. health care reform for people with diabetes.

Public and private health plans generally cover long-term diabetes complications, including amputations, blindness, end-stage renal disease, heart attack and stroke.

It’s time to give people with diabetes affordable health coverage to prevent or delay these costly and life limiting complications.

The shift is better for people with diabetes and their families, and a wiser investment of our nation’s health care dollars in the face of the diabetes epidemic.

health plan design solutions

Employer Initiatives

The Diabetes Leadership Council partners with employers, employer organizations, and benefit consultants and proposes simple solutions to reduce plan risk and out-of-pocket costs for employees and their dependents:

  • Insulin exemption: adding insulin to a list of medicines that are covered during the deductible phase
  • Discount and rebate sharing: passing through manufacturer’s rebates to employees at the pharmacy
  • Co-payments: employee cost sharing through reasonable, predictable co-payments instead of variable coinsurance
  • Technology access: cover all FDA-approved diabetes devices and technologies

DLC has teamed up with JDRF and their Coverage2Control initiative to raise employer awareness and promote implementation of these value-based insurance design features — improving diabetes care quality with coverage that reduces overall plan costs and mitigates risks to employers and their employees.

Want to learn more? View these downloads:

Request an Employer Presentation

If your HR or Employee Benefits team wants to learn more about optimizing diabetes coverage, or to schedule a DLC presentation at your meeting or conference email [email protected]

Reducing Insulin Out-Of-Pocket Costs

DLC is committed to reducing insulin costs in the U.S. Insulin is an essential, life-sustaining component of diabetes care; affordability should not depend on patients’ shopping savvy or savings programs. It’s encouraging to see policymakers paying attention to the problem, but policy changes take time and many people with diabetes struggle to afford insulin today. Personal circumstances and insurance plans vary so there’s no one-size-fits-all shortcut – but if you are uninsured, underinsured or in a high deductible plan these steps may help reduce your out-of-pocket cost for insulin and other diabetes medicine and supplies.

STEP 1
Check Your Coverage First

If you have insurance, check your plan’s website or app for a cost estimator or call the member services number on the back of your insurance card to find out which insulins are covered and which pharmacy your plan prefers. You might save hundreds of dollars by filling your prescriptions at a different retail or mail order pharmacy. Preferred pharmacy status can change during the year so know before you go.

STEP 2
Talk to your diabetes care team if insulin is unaffordable

Help is available for people struggling with high insulin costs. Often the best place to start is with your diabetes care team – whether it’s an endocrinologist, family practitioner, physician assistant, nurse practitioner, diabetes care and education specialist, dietitian, pharmacist or social worker.

They could help bridge short-term gaps with samples or temporarily transitioning to lower cost insulins. They also can help people with diabetes reduce longer term insulin costs – by navigating insurance formularies and coverage appeals; writing prescriptions to optimize insulin units available under 30- or 90-day dispensing limits and cost sharing; or documenting medical necessity to support coverage appeals or assistance program enrollment.

Several new insulins were recently introduced at significantly lower list prices – including a follow-on biologic and authorized generic analog insulins. Your diabetes care team can help you decide which insulin is best for you.

STEP 3
Enroll in patient assistance programs

Insulin manufacturers Lilly,  MannKind,  Novo Nordisk and Sanofi offer various patient assistance and discount programs. You can contact manufacturers directly or go to getinsulin.org to understand options for immediate and long-term insulin needs. Consumer costs range from zero to $100 for a month’s supply of insulin, depending on the program and individual’s eligibility. ADCES (the Association of Diabetes Care & Education Specialists) also assembled valuable guides to help connect people with diabetes and their health care providers to assistance programs, discount plans and other resources. Eligibility and application requirements vary but you could qualify for discounted insulin, other diabetes medications, supplies or other assistance even if you have insurance or earn a middle class income.

STEP 4
Take advantage of discount programs

Checking prices at GoodRx, Blink Health or InsideRx could shave hundreds of dollars from your pharmacy bill. Visit their websites or download the apps to access discount codes and coupons, and compare prices at nearby pharmacies. You may need to sign up in advance but there is no cost to use these services. If you have insurance remember to check whether cash payments count toward your deductible.

STEP 5
Find a community health center or other low-cost health care provider

Search here or contact your state or local health agency to find a community health center nearby. These hospitals and clinics purchase discounted insulin and other medicines through a federal program so their pharmacies can dispense them at no or low cost to their patients. Wait time to see a provider can be long but community health organizations and facilities nationwide form a vital safety net for uninsured or underinsured people with diabetes.

STEP 6
Ask for the pharmacy’s cash price

Cash prices vary so call several pharmacies – chains and independents – to compare. Even if you have insurance, the cash price could be lower than your co-insurance or co-payment. Cash payments may not apply to your deductible so decide which option is best for you.

STEP 7
Talk to your employer about insulin costs

DLC has partnered with JDRF to share with employers how health benefit plans can be structured to help people with diabetes afford the care they need by:

  • Passing along discounts and rebates at the point of sale
  • Keeping cost sharing low and predictable throughout the year
  • Covering the full range of insulin delivery devices and other vital diabetes supplies and services
  • Adding insulin to the preventive drug list, exempt from deductibles and cost-sharing

If your employer offers health insurance, learn more about the DLC Access to Insulin Employer Initiative. Visit JDRF and DPAC’s Affordable Insulin Project for resources to help you understand your coverage and talk to your employer about insulin costs

STEP 8
Use member warehouse pharmacies and prescription discounts

If you are a Costco or Sam’s Club member, their mail order and retail pharmacies may save you money. Check online and talk to the local pharmacy to find the lowest price. Many states allow non-members to use warehouse pharmacies too. You won’t need a member card to enter the warehouse – just tell the door greeter you’re a pharmacy customer.

Download The PDF

Insurance Literacy

Diabetes is nearly impossible to affordably manage without health insurance. Management requires multiple prescriptions, devices, services, and supplies. Those costs quickly add up when people with diabetes are in health plans that do not provide first dollar, pre-deductible coverage or low, predictable cost sharing. 

The Diabetes Leadership Council believes that diabetes care is preventive care. Every person with diabetes needs preventive coverage for their diabetes management essentials, benefitting from their health coverage on day 1 of the plan year instead of paying a high annual deductible before insurance kicks in. 

First dollar, preventive coverage for comprehensive diabetes care offsets much more costly complications such as heart attack, stroke, amputations, blindness or kidney disease.

We work with employers to structure health benefits with first dollar coverage, rebate pass through and other features that reduce plan risk and manage diabetes costs. And we work with other advocacy organizations to improve insurance literacy – helping people with diabetes choose and use the right health plan. 

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