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MedicareDoes Medicare Cover Insulin?

Does Medicare Cover Insulin?

Yes, Medicare covers insulin, and recent legislation has significantly reduced the cost for Medicare beneficiaries. Under the Inflation Reduction Act, insulin covered by a Medicare Part D plan is now capped at $35 per month per insulin product.

The $35 Insulin Cap

Starting in 2023, Medicare Part D plans cannot charge more than $35 per month’s supply of covered insulin. This applies to all insulins on a plan’s formulary, regardless of which coverage phase you are in. You do not need to meet your deductible before the cap applies.

Insulin Coverage Through Part B

Medicare Part B (not Part D) covers insulin used with an insulin pump. If you use an insulin pump, your insulin is classified as durable medical equipment and covered under Part B at 80% (you pay 20% after the Part B deductible).

Types of Insulin Covered

Insulin typeTypical coverage
Rapid-acting (Humalog, NovoLog, Fiasp)Part D — $35/month cap
Long-acting (Lantus, Basaglar, Toujeo)Part D — $35/month cap
Intermediate-acting (NPH)Part D — $35/month cap
Insulin for use in pumpPart B — 80% coverage (DME)

Insulin Supplies

Insulin syringes, pen needles, alcohol swabs, and insulin pumps are covered under Part B as durable medical equipment or medical supplies. Your Part D plan may also cover lancets and test strips — check your plan’s formulary.

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