Insulin Pumps for Underinsured Mellitus Patients
General Eligibility
To qualify for a free, refurbished insulin pump you must have diabetes, legally reside in the United States, and:
- Submit a doctor's prescription for an insulin pump;
- Have no insurance coverage for an insulin pump; and
- Have satisfactorily demonstrated other reasons for financial hardship, and
- All applicants must show that they will be able to afford pump supplies.
About the free insulin pump program
This program assists qualifying persons of any age with assistance in obtaining a recertified insulin pump. This program requires participation from your doctor. We will not work with anyone who does not have a doctor that has prescribed a pump. Under this program we do not reimburse for expenses already incurred or provide cash assistance to help with a co-pay for a pump. We will not help you purchase or obtain an insulin pump through the Internet, private sale, or any other means.
To qualify you will have to show financial hardship AND how you will pay for the pump supplies on your own. If you are approved to for a free pump you need to know the following:
- All free pumps that we send have been previously used. Pumps are donated to us and we then have them recertified (that means we send them to the pump company who made them and have them checked out and repaired if necessary). Sometimes, a pump company will choose to upgrade the pump for free.
- The recertification fee for a used pump is $200.00. You will need to pay this fee prior to a pump being sent you. You do NOT have to pay this fee to apply for a free pump -- this fee is only due if you are approved and we have a specific pump for you. Do NOT send money with your application. In some cases, a pump company will recertify your pump for free. If we do not have to pay a fee, neither do you.
- We will not send a pump directly to you. All pumps must be sent to a doctor, CDE, or your local insulin pump representative. Under no circumstances can we send a pump directly to a client. All pump training, maintenance and any future repairs of the pump will be your sole responsibility.
About Recertified Pump Warranties
Some pumps donated to us are about four years old, however, many pumps we receive are 1-2 years old and still under warranty. Insulin pump companies often choose to upgrade pumps for free. Any pump you receive will have been sent to the manufacturer just prior to it being placed with you to be checked, service, and recertified. Federal law prohibits the transfer of warranties on medical devices. Original pump warranties are not transferable to you. In most cases, the pump company will offer a limited warranty for free, and allow the new pump user to purchase an extended warranty. The purchase of any additional warranties are the sole responsibility of the person who gets the pump and not iPump's responsibility.
Download and Print The Application
Print COMPLETE APPLICATION in one .pdf file.
You can also print individual files but you MUST print and complete all these forms to apply:
We Do Not Mail Hardcopy Applications
Due to severe budget restrictions, we are no longer able to mail applications. If you do not have a printer, please visit your local library or have a friend or relative print an application for you. Your doctor's office might even be willing to print one for you.
We regret this inconvenience but were spending an average of $200 per month mailing applications and need to preserve our funds for direct assistance programs.
Social workers and agencies - we CANNOT send applications to your own clients/patients on your behalf. If you have someone you are working with, you need to print the application for them. We were receiving many requests from social workers to mail applications only to have the applications returned to us as a bad address. This is very costly to our organization. We ask that you please print the applications and give them to your clients (or mail them, if necessary).
Disclaimer: Submitting an application is not a promise or guarantee by iPump.org, Inc. that an applicant will be approved. Our ability to help others is restricted by available program funding at any give time. Applications are reviewed by iPump.org's Program Director and approved by the board of directors based upon eligibility, need and individual program funding availability. We offer no promises or guarantee that we can meet the needs of all applicants but we try to help as best we can.
Recommended reading before you apply
Disclaimer: Submitting an application is not a promise or guarantee by iPump.org, Inc. that an applicant will be approved. Our ability to help others is restricted by available program funding at any give time. Applications are reviewed by iPump.org's Program Director and CEO, and approved by the board of directors based upon eligibility, need and individual program funding availability. We offer no promises or guarantee that we can meet the needs of all applicants but we try to help as best we can.