Insulin Costs and Coverage in Medicare Part D

(By Juliette Cubanski, Tricia Neuman, Sarah True, and Anthony Damico for Kaiser Family Foundation)

In May 2020, the Trump Administration announced the number of Medicare Part D plans that will be participating in 2021 in a Medicare Innovation Center model to address out-of-pocket costs for insulin products for Part D enrollees. Under the voluntary model, participating Part D plans can offer coverage of insulin for a flat monthly copayment of no more than $35, in contrast to varying cost-sharing amounts during different phases of the Part D benefit under the current design. The model comes in response to rising prices for insulin, which have attracted increasing scrutiny from policymakers, leading to congressional investigations and overall concerns about affordability and access for people with diabetes who need insulin to control blood glucose levels. Continue reading here…

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