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Diabetic macular edema (DME)

$3,375 guaranteed award   |   $4,500 maximum award

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Fund summary

Eligibility

Approved medications

Diagnosis codes

How to apply

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

Answer a few short questions to find out if you might be eligible for this fund.

Takes 3-5 minutes

No documents or personal information needed

Please confirm you are in treatment for this condition by a healthcare provider in the U.S. or U.S. territories.

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.

Diagnosis codes

E08.311, E08.3211, E08.3212, E08.3213, E08.3219, E08.3311, E08.3312, E08.3313, E08.3319, E08.3411, E08.3412, E08.3413, E08.3419, E08.3511, E08.3512, E08.3513, E08.3519, E08.3521,

How to apply

  1. If your fund is open, apply online 24/7, or call 866-512-3861, Monday – Friday, 8:30am – 5:30pm ET.

  2. Answer pre-screening questions to confirm eligibility. Have your income, medication, diagnosis, and insurance information ready.

  3. Complete the application and get an instant approval decision. You can begin using your grant right away.

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How does it work?

You can use your TotalAssist grant award to help pay for out-of-pocket healthcare expenses.

Learn more

Need help applying?

Call us at 866-512-3861 to apply by phone, Monday through Friday, 8:30am - 5:30pm ET.

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Related organizations

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Explore resources beyond TotalAssist

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.

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