Due to high volume, manual claims processing times are taking longer than usual. We apologize for the inconvenience and ask that you not resubmit the same claim multiple times. This will help ensure our team is able to process claims as quickly as possible. To check your claim status, please log in to your portal account or use our 'Quick search' tool. Thank you for your cooperation and understanding.
Help with healthcare costs for diabetic macular edema
This TotalAssist fund helps you pay for out-of-pocket healthcare costs, including medication copays, coinsurance, and deductibles, health insurance premiums, and other expenses. Check your eligibility with our quick and easy tools below. If this fund is open, apply today for an instant approval decision and use your grant funding right away. Learn how TotalAssist helps you.
Eligibility criteria
To be eligible for this fund, you must:
Have a confirmed diagnosis and are in treatment for diabetic macular edema, or planning to begin treatment in the next 60 days, or have been in treatment in the past 6 months. This includes active surveillance of a condition
Have government-insured coverage that covers your qualifying expenses
Have an income at or less than 500% of the Federal Poverty Level, adjusted for your regional Cost of Living Index (COLI). What is this?
Be a legal resident and receive treatment in the U.S. or a U.S. territory
Be prescribed a medication or product listed in the approved medications, listed below
Quick eligibility checker
1. Treatment
2. Insurance
3. Income
Not sure if you’re eligible for TotalAssist?
We encourage you to check your eligibility or complete pre-screening to confirm. There’s no risk and applying online takes less than 15 minutes. Start your application online or by phone and complete the pre-screening questions to confirm eligibility.
Approved medications
Patient Advocate Foundation covers all the prescription medications for each diagnosis, including generic or bioequivalent drugs, that meet any of the following criteria: FDA-approved, listed in official compendia, and/or listed in published evidence-based or clinical guidelines.
Avastin (Bevacizumab)
Beovu (Brolucizumab)
Eylea (Aflibercept)
Iluvien (Fluocinolone Acetonide)
Lucentis (Ranibizumab)
Ozurdex (Dexamethasone)
Triesense (Triamcinolone)
Vabysmo (Faricimab-Svoa)
About the disease
Diabetic macular edema (DME) is a severe complication of diabetic retinopathy that results from inadequately treated diabetic mellitus. It is now the most common cause of vision impairment in patients with diabetes mellitus. DME is caused by swelling in part of the retina caused by blood vessels that leak into a portion of the retina called the macula. This swelling causes blurred vision; objects may appear wavy, colors may be dull or faded, or objects may appear to be different sizes in one eye compared to the other.
Patient Advocate Foundation knows that patients may need support, information, and resources beyond TotalAssist. This can include services like case management, help with living expenses, and much more. Search our National Financial Resources Directory, find community specific resources, and explore our patient education library.