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| Applying For Assistance - Step 3 |
To print our applications you need Adobe or another .pdf reader. Get Adobe Reader (free software download)
Step 3. Select An Assistance Program
There are three assistance programs designed to help you with your diabetes care. Simply select a program, print out the attachment (they are all short and simple) and attach it to your application.
|
Program |
General description of program and enrollment status |
|
Request for Essential Diabetes Supplies (REDS) |
Free diabetes care supplies (to qualifying individuals) including: testing supplies, syringes, pen needles, and insulin pump supplies (as we have them available) to those in need. ENROLLMENT: Currently Accepting Applications |
|
Insulin Monthly Assistance Program (IMAP) |
Offers temporary, emergency financial assistance for insulin, BYETTA, and Symlin for 1-3 months. ENROLLMENT: Program Full/Closed: Open Enrollment begins again in June 2008 |
|
Insulin Pumps for Underinsured Mellitus Patients (IPUMP) Print Attachment 3 for IPUMP Assistance If you are applying for a FREE pump you must also print Form DWRL-10 "Disclaimer, Waiver and Release of Liability Form" |
Two ways this program can help: 1. Up to $1,000 of financial assistance to help with the purchase of a first insulin pump; or ENROLLMENT: Program Full/Closed: Open Enrollment begins again in June 2008 2. A free recertified insulin pump. A $200 recertification fee may apply if you receive a free pump through this program so please read all program information carefully. ENROLLMENT: Currently Accepting Applications |
I have chosen an assistance program and am ready to move on!
Step 4. Print Our Check List
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 available. 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
What type of assistance does IPump offer?
Steps to apply
Step 1. Eligibility test
Step 2. Select application
Step 3. Select assistance
Step 4. Print our check list
Step 5. Mail application
