Insulin Pump Users Get $35 Cap on Insulin
Insulin Pump Users Get $35 Cap on Insulin
If you use a traditional insulin pump that’s covered under Medicare Part B’s durable medical equipment benefit, the $35 cap on your insulin costs starts July 1, 2023. Beginning July 1, 2023, your cost for a month’s supply of Part B-covered insulin for your pump can’t be more than #35, and the Part B deductible won’t apply. If you have Medicare Supplement Insurance (Medigap) that pays your Part B coinsurance, that plan should cover the $35 (or less) cost for insulin.
The U.S. Department of Health and Human Services (HHS) released revised drug price negotiation guidance from the Centers for Medicare & Medicaid Services (CMS). The guidance is a critical step in implementing the the Inflation Reduction Act (IRA), which will allow Medicare to negotiate lower drug prices on behalf of people with Medicare.
CMS will announce the first 10 drugs selected for negotiation by September 1, 2023. The first round of negotiations will occur during 2023 and 2024. The prices that are negotiated will be effective starting in 2026; however, insulin costs will go into effect July 1, 2023.
To read more on how the $35 insulin cap is already benefiting seniors and other Medicare enrollees across the country, visit: https://aspe.hhs.gov/reports/insulin-affordability-ira-data-point.
You can also read more about Medicare’s coverage and insulin costs here.
- Visit Medicare.gov/coverage/insulin.
- Visit Medicare.gov/about-us/inflation-reduction-act.
- Call 1-800-MEDICARE (1-800-633-4227). TTY users can call 1-877-486-2048.
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Sources:
https://www.hhs.gov/about/news/2023/06/30/hhs-announces-actions-lower-healthcare-costs-allow-medicare-negotiate-lower-drug-prices.html
http://chrome-extension//efaidnbmnnnibpcajpcglclefindmkaj/https://www.medicare.gov/media/publication/12172-7-things-to-know-about-medicare-insulin-costs.pdf
https://www.hhs.gov/news
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