Recommended reading before you apply
About our assistance programs
What type of assistance does iPump offer?
Frequently Asked Questions
Steps to apply
Step 1. Eligibility test
Step 2. Select application
Step 3. Select assistance
Step 4. Mail application
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. |
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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 complete application and a HIPAA Consent Form. THE HIPAA CONSENT FORM IS REQUIRED BY FEDERAL LAW AND WE AND CANNOT PROCESS YOUR APPLICATION WITHOUT THIS FORM BEING SIGNED AND SUBMITTED WITH YOUR APPLICATION.
Read About HIPAA Law and how it protects your privacy (outside government link).
You may ONLY apply for one program every 6 months (programs highlighted in pink are not currently accepting new applications).
You may ONLY apply for one program every 6 months (programs highlighted in pink are not currently accepting new applications).
Program |
General description of program and enrollment status |
Request for Essential Diabetes Supplies (REDS)
About the REDS program
Print Complete REDS Application |
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: Program Full/Closed to Adults. We are accepting applications for children under age 21.
Subscribe to our Newsletter if you wish to receive announcements about this and other iPump programs. |
Insulin Monthly Assistance Program (IMAP)
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Offers temporary, emergency financial assistance for insulin, BYETTA, and Symlin for 1-3 months.
ENROLLMENT: Program Full/Closed. Subscribe to our Newsletter if you wish to receive announcements about this and other iPump programs. |
Insulin Pumps for Underinsured Mellitus Patients (iPump)
Two ways this program can help: cash assistance and free insulin pumps.
About the iPump program
Print Complete Insulin Pump Application
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" |
1. Up to $1,000 of financial assistance to help with the purchase of a first insulin pump. ENROLLMENT: Program Full/Closed. Subscribe to our Newsletter if you wish to receive announcements about this and other iPump programs. |
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. (If we have to pay the $500 recertification fee, you will be required to contribute $200 of this fee. Sometimes, pump companies waive this fee. If we are not charged a fee, you will be be charged either.)
ENROLLMENT: Currently Accepting Applications for Animas Insulin Pumps for adults and children without insurance who have type 1 diabetes. |
I have chosen an assistance program and am ready to move on!
Remember... we will not process your application with a signed HIPAA Consent Form.
Step 4. Where to Mail Your Application |
