Tell Your Story, Inspire Change
We are seeking patient stories for individuals who have been negatively impacted by a Copay Assistance Accumulator Program (CAAP) included in their insurance plan as part of an effort to show the impact of these unfair programs. Note that this does not need to be on insulin or even a diabetes drug.  It can be for any prescription drug where the patient used a manufacturer’s coupon but did not get credit for the coupon against their deductible or out of pocket max.  

Please fill out the survey questions below and we will be in touch with you shortly! 
Have questions - contact us at info@diabetespac.org 
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Learn More about Copay Accumulator Adjustment Programs
First and Last Name *
(We will only use your first name and last initial in any public testimonial)
Email *
(For when we need to get in touch with you)
State *
Medication Name & Date Purchased *
Dollar ($) Value of Coupon Provided by the Manufacturer *
Dollar ($) Amount You Paid After Applying Coupon  *
Dollar ($) Amount Your Insurance Showed You As Paying  *
Insurance Plan *
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