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This is shocking. Fourteen years of working in the Medicare arena, I’ve never seen such a practical and needed policy change that will truly help millions of Americans. I’m thinking it will likely save lives and improve the quality of life for many. Starting in January of 2021, six months from now, the vast majority of people with Medicare Part D will pay only $35 per month for their insulin copay! Wow.

The full generic cost for Humalog now is $320, the brand version is $633. Novolog, Basaglar, Lantus, Tresiba, and Levemir are not much better. Currently people’s copays may not be as high as the full price, but it is common to see people on insulin have to shell out $100’s of dollars in some months for their copays or coinsurance. This will change starting the next Annual Enrollment Period (AEP) October 15 – December 7…

The following is an exact quote from the official CMS Medicare website, on May 26, 2020, “…under President Trump’s leadership, the Centers for Medicare & Medicaid Services (CMS) announced that over 1,750 standalone Medicare Part D prescription drug plans and Medicare Advantage plans with prescription drug coverage have applied to offer lower insulin costs through the Part D Senior Savings Model for the 2021 plan year. Across the nation, participating enhanced Part D prescription drug plans will provide Medicare beneficiaries access to a broad set of insulins at a maximum $35 copay for a month’s supply, from the beginning of the year through the Part D coverage gap. The model follows on the Trump Administration’s previously announced 13.5 percent decline in the average monthly basic Part D premium since 2017 to the lowest level in seven years.”

https://www.cms.gov/newsroom/press-releases/president-trump-announces-lower-out-pocket-insulin-costs-medicares-seniors

Have a Medicare question? Email or call me: medicare.individual.admin@cabenefitsgrp.com or 614.389.5755 x112.

Ty Cramer, Medicare Specialist