Washington Medicaid may cover the cost of your Diabetic Supplies!

Diabetic Supplies may be covered by Washington Medicaid

Washington Medicaid will cover the cost of your Diabetic Testing Supplies. You may qualify for a No Cost* Meter!

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 Diabetic Supplies!

Get a No Cost* Glucose Meter when you signup today, just for having Washington State Medicaid Insurance! Enroll Today!

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 Tricare are:

Test Strips
Lancets
Control Solution
Lancing Devices

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 Medicaid 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:*

Tricare Insurance covers the cost of diabetic supplies including glucose meters, test strips, and more.

Insurance Information

My Primary Insurance is:*

Medicare or Insurance ID #:

Secondary Insurance Company:	Secondary Insurance ID #:

How Many Daily Glucose Tests?

What products are you interested in?

Diabetes Impotence

Comments:

Respiratory Heating Pads

We look forward to speaking with you!

To learn more, visit our web site at www.NorthCoastMed.com

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