You may qualify for no cost* Diabetic Supplies with your Aetna Health Care Insurance plan

Receive a No Cost Blood Glucose Monitor from North Coast Medical Supply with your Aetna Insurance Plan

Aetna, Medicare and Most Private Insurance Companies will Pay for Your Diabetes Testing Supplies, including Glucose Meters, Test Strips, Lancets and more.

We work with your doctor to obtain your prescription and call you on a 30, 60, or 90 day basis as a courtesy to ensure you always have enough supplies on hand. No more traveling to the pharmacy for testing supplies!

For visiting our site from one of our partners receive a NO COST* Blood Glucose Monitor when you sign up to receive your testing
supplies by mail!

Choose from a variety of high quality, accurate meters!

Receive a Diabetes Health &
Wellness Kit as an added bonus

The diabetic testing supplies covered by Aetna are:

Test Strips
Lancets
Control Solution
Lancing Devices
Syringes

To give us a better understanding of your requirements and needs - please fill out the form as much as you desire and one of our Aetna Insurance Verification Specialists will contact you regarding your specific benefits.
All information is kept strictly confidential.

First Name:*	Middle Initial:	Last Name:*

Telephone:*

Email Address:

Street Address:*

Address Line 2:

City:*

State:*

Zip Code:*

Date of Birth:*

Insurance Information

My Insurance is:*

Enter your Medicare number:	Secondary Insurance Company:

How many times a day do you test your blood sugar level?

Comments:

We look forward to speaking with you!

To learn more, visit our website at www.advanceddiabetessupply.com

* No cost Blood Glucose Monitor offer is valid when you sign up to receive testing supplies by mail through Advanced Diabetes Supply.