More than 3.3 million people with Medicare use one or more of the common forms of insulin every day. Unfortunately, the cost of insulin has nearly tripled over the past ten years, from about $100 to $300 a vial, and out-of-pocket costs for the drug for people with Medicare can significantly fluctuate from month to month, making budgeting and management of a person’s diabetes more difficult.
Starting October 15, 2020, people with Medicare will be able to enroll in a Medicare drug plan that offers insulin for no more than a $35 copay for a month’s supply. Coverage will begin on January 1, 2021. While all plans that are participating in Medicare’s new “insulin savings model” guarantee that your cost-sharing is capped at $35 for a month’s supply of insulin, some plans may offer even lower copays. Participating plans cover different types and brands of insulin, and it’s important to check each plan’s formulary to find out your exact cost, starting in the deductible phase, and going through the initial coverage, and coverage gap phases of your Medicare drug benefit. By enrolling in a participating plan, people with Medicare may save hundreds of dollars per year on your out-of-pocket costs for insulin, and you’ll always know exactly what you’ll be paying each month.
To find a participating Medicare plan, beginning on October 1, visit Medicare.gov/plan-compare and search for plans in your area. When you see a list of plans resulting from your search, click on the “Filter Plans” button in the upper right of the screen. Just under that, you’ll see a checkbox called “Insulin Savings.” Check that box to filter your results to show only plans that will offer insulin savings for 2021. You can also call 1-800-MEDICARE (1-800-633-4227) for help finding a participating plan.
For more information, visit Medicare.gov or call 1-800-MEDICARE (1-800-633-4227). TTY users can call 1-877-486-2048. For people with Medicare who have diabetes and use insulin, it’s important to have access to affordable insulin to manage blood sugar. If you’re chronically unable to afford what your health care provider has prescribed, you’re at greater risk for serious complications from uncontrolled diabetes, including vision loss, kidney failure, heart attack, stroke, and chronic nerve pain. The cost of insulin should never keep it out of the hands of people whose health depends on it, and Medicare’s insulin savings model is designed to ensure that those who need it get it. This new model just may help you better manage your health, and your pocketbook, in 2021.
