Does Medicare Cover Insulin?
Medicare Part D prescription drugs plans (PDPs) typically cover insulin. You may also consider enrolling in a Medicare Advantage plan that covers prescription drugs, which will likely cover insulin.
Generally, Medicare Part B (Medical Insurance) covers some of the services and supplies needed to manage diabetes, but not insulin.
What Medicare Plans Cover Insulin?
Certain diabetes drugs and supplies aren’t covered by Original Medicare. To get coverage for injectable insulin, you may consider joining a Medicare prescription drug plan (Part D) or a Medicare Advantage (Part C) plan that covers prescription drugs.
Medicare plans with drug coverage typically cover:
Injectable insulin not used with a pump
Certain diabetic supplies used to inject or inhale insulin (syringes, needles, insulin pens, alcohol swabs, and gauze)
Anti-diabetic drugs used to maintain blood sugar
You can compare Part D plans available where you live and enroll in a Medicare prescription drug plan online when you visit MyRxPlans.com.
How Much Does Insulin Cost With Medicare Drug Plans?
Medicare Part D plans and Medicare Advantage are sold by private insurance companies. Plan availability and costs may vary.
Each Medicare drug plan has its own list of covered drugs and rules for coverage, known as a formulary.
Your actual drug coverage and costs will depend on:
The type of drugs you use
The Medicare Part D plan or Medicare Advantage plan you enroll in
Whether you go to a pharmacy in your plan’s network
Whether the drugs you use are on your plan’s formulary
Whether you get Extra Help paying your Part D costs
Be sure to speak with a licensed insurance agent to get details on:
Whether your Part D plan or Medicare Advantage plan covers your insulin supplies
How much these drugs will likely cost with your Part D coverage
What network of pharmacies and suppliers your plan uses
A Medigap Plan Can Help Cover Your Out-of-Pocket Diabetes Treatment Costs
Even with Original Medicare's broad range of coverage, it leaves numerous out-of-pocket costs to recipients, including deductibles, copayments and coinsurance.
A Medicare Supplement Insurance (Medigap) plan can help cover some of these costs.
For example, Medicare Part B covers medically necessary foot care, diabetes screenings and some diabetic test supplies for beneficiaries who have diabetes.
If you receive covered care, you will typically be responsible for paying the Part B deductible ($240 per year in 2024) and a 20% Medicare Part B coinsurance.
If you have a Medigap plan, it will help pay for the Part B coinsurance costs of your covered diabetes treatment.
You can have a Medigap plan and a Medicare Part D prescription drug plan at the same time.
Medigap plans and Medicare Advantage plans are not the same thing, however. You cannot have a Medicare Advantage plan and a Medigap plan at the same time.
Compare Medicare Supplement Plans Where You Live
A licensed agent can help you decide on a Medicare option that works for you.
Call to speak with a licensed agent and compare Medigap plans available where you live.
Find Medicare plans in your area.Compare Plans
Christian Worstell is a health care and policy writer for MedicareSupplement.com. He has written hundreds of articles helping people better understand their Medicare coverage options.
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