{"id":29463,"date":"2023-10-25T15:20:54","date_gmt":"2023-10-25T15:20:54","guid":{"rendered":"https:\/\/isafespend.com\/personal-finance\/retirement\/for-those-with-diabetes-on-medicare-part-d-insulin-is-35-if-its-covered\/"},"modified":"2023-10-25T15:20:55","modified_gmt":"2023-10-25T15:20:55","slug":"for-those-with-diabetes-on-medicare-part-d-insulin-is-35-if-its-covered","status":"publish","type":"post","link":"https:\/\/isafespend.com\/?p=29463","title":{"rendered":"For Those With Diabetes On Medicare Part D, Insulin Is $35…If It\u2019s Covered"},"content":{"rendered":"
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Open Enrollment began October 15, and I tackled one of our first reviews for a long-time client. Alicia has had the same drug plan since 2018 when she started on Levemir insulin. It was quite a surprise when she learned that her plan would drop this drug from its formulary in 2024.<\/p>\n

Alicia was frustrated because she thought the Inflation Reduction Act capped all insulins at $35. I suspect many people believe that. Headlines like, \u201cSenior citizens won\u2019t pay more than $35 a month for insulin as new drug provisions kick in,\u201d can give that impression. However, as they say, the devil is in the details. In a frequently asked questions document, the Centers for Medicare and Medicaid Services stated that, \u201cif an insulin is a covered insulin product, the $35 cap for a month\u2019s supply for each insulin product applies, as of January 1, 2023.\u201d CMS defines covered insulin as one that is included on a Part D sponsor\u2019s formulary, the list of drugs that a plan covers. The FAQ document also notes a plan can change its formulary, which includes adding or removing drugs.<\/p>\n

More plans are changing coverage of insulin <\/strong><\/h2>\n

This raised a question. Are other drug plans changing their formularies in response to this new rule? I decided to do a quick check of the 22 stand-alone Part D plans sponsored by eight insurance companies in Alicia\u2019s area. I identified 10 insulins that 65 Incorporated <\/em>clients take in five categories: rapid-acting, short-acting, intermediate-acting, long-acting and mixed. Here are some of my observations.<\/p>\n

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