41 Comments
If you have met your health insurance prescription deductible for the year, how much is your co-pay for one month’s supply of insulin?
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I am on Medicare so Walgreens sends my insulin through as durable medical equipment so I pay nothing for it.
Donna, congratulation!
I am on medicare. My CVS out of pocket expense is $108.33 monthly for DME insulin. I have seen the cost vary by state, by county, by month, by day, and yes, by the hour while the pharmacist stayed on the phone. It’s like being in front of a fun-house mirror. Only it isn’t funny.
Wow! Congratulations.
Ahh Life, thanks for explaining our chaotic American health care situation. 🙂
I have met my deductible but insulin is fully covered by Medicare Part B since I use an insulin pump.
I do not have a prescription deductible but on Medicare advantage plan. I am now in catastrophic coverage after being in and out of donut hole so for the last 3 mo prescription I paid $27 ? A tiny fraction of what I pay normally I have never been in catastrophic before but in sulking always gets me in the donut hole. So I switched this yr to a plan that will offer $30 per month max for insulin
Insulin it Tier 2 for me so I have no deductible but I do have to pay $15 for a 3 month supply.
$200, because i use Fiasp and Tresiba both of which are not my Medicare Advantage’s preferred insulins, but which are definitely better for my control.
There was only one advantage plan that covered my insulin. For that reason I went with a gap plan. With that I pay $28/vial. I hope you looked for other plans.
I thought Medicare part B was covered 80%. And we pay 20% unless we have a medigap policy as well
I pay $0 for insulin because it’s tier6 in my $600/yr part D policy
I have no deductible on my Medicare Advantage plan, so until I meet my out of pocket maximum my Novolog is $800+ for a 3 month supply. Once that is met it cost me nothing. The plan pays 20% only because I’m allergic to the preferred brand.
Since I can’t afford that on my fixed income, I ration my insulin.
So sorry you have to ration. Nobody should have to do that.
Larry, what state do you live in? I’m envious.
Kristine, being forced into rationing is outrageous.
I get my Novolog insulin with 90 day prescriptions. I pay $55 each 90 days. This site says my answer was $20-$30 per month, but I clicked on $10-$20 per month. Something must have changed when I clicked “submit.”
My annual deductible only applies towards DME prescription items and Doctor visits, but it’s only a $750 annual deductible. I think pharmacy coverage is changing next year so no idea if prices will be the same as this year or not. In 2021, ALL my pharmacy Benefits covered prescriptions came at $0 co-pay except for two non-Diabetes related medications that carried a co-pay of $2 – $6. But the only Pharmacy Benefits covered Diabetes related item that has had a co-pay was my infusion sets that CVS Caremark mail-order pharmacy insisted they didn’t have and couldn’t get until I had them do a search on their computer for them and they said they thought the computer was wrong since they couldn’t get any Insulin Pump supplies, but they’ve been able to send my infusion sets as a pharmacy benefit with a $70 co-pay first shipment and only a $20 co-pay on the second shipment.
Currently, the ONLY pump supply I need to get under my DME coverage is my Insulin Pump cartridges.
The only year I actually met my deductible was when I had my heart attack. I took full advantage and got procedures done and stocked up on the 2 insulins Im on
Even though my co-pay is $35 for one month’s supply, I actually don’t use all of the insulin that is supplied by the insurance so I just order when I actually need insulin which is about every six weeks. My insurance pays 100% of my pump and CGM supplies so I feel I get a good bargain.
My Medicare Advantage Plan has no deductible so I pay $47 for 2 vials, a 6 to 7 week supply, but once in the doughnut hole I pay $134 for 2 vials.
I get 7 bottles for a 3 month supply (which actually lasts for 4 months or more.) My insurance has a maximum out-or-pocket of $175 for any one order. So that works out to be about $60 per month.
I’m lucky to have standard Medicare (80% coverage for pump insulin) with a supplement that covers the 20% deductible.
My co-pay for insulin has been $40 for a three-month supply. So 13.33 per month would be my out-of-pocket cost.
I don’t have a deductible on prescriptions. My primary coverage is thru my spouse’s employer. My secondary insurance is Medicare. All but $10 of my 2 vial a month Novolog prescription is picked up by the primary insurance and Medicare pays a small portion under Part B because I use a pump that covers the remaining balance. I pay plenty for all other DME (pump insulin cartridges, infusion sets, Dexcom CGM sensors and transmitters) because of primary insurance co-insurance 20% + 20% co-pay on pump and CGM supplies. Medicare as a secondary does not cover any co-insurance charges.
It just seems so wrong, but after insurance I still pay $202 for 90 day supply. I tried to bill through Medicare Part B (with my insulin pump), but they will now only pay for the generic form of Novolog or Humalog. I can’t win.
Medicare Part B and my Medicare Supplement plan pay 100% for my Novolog, not the generic. Does this vary from state to state?
I am very fortunate that I am now on My husbands carpenters insurance. They have a Wellness facility and if you use their pharmacy prescriptions, with a few exceptions, are free
My insulin is covered under part B of Medicare because I wear a pump DME durable medical equipment. The plan I have chosen a pay high premium and have no deductibles and no co-pays
I go by a 6 month supply. 150.00 Last me about 10 months.
I am a senior on Medicare and have a seperate part D insurance plan which covers insulin at no deductible. However, I pay a premium of $58 monthly to carry this Cigna coverage.
I am on Medicare and on an insulin pump.
Because of that, insulin is covered under Medicare Part B.
Between Medicare and my supplemental health insurance I pay nothing throughout the entire year.
Not all pharmacies participate though.
I use Walgreens but there are others.
I have an employer provided HMO plan. I pay $15 per Rx and 50% if my pump/ CGM supplies until I spend $1500 out of pocket. After that they’re free. I usually just get my Dec refills free.
Even with a deductible I pay nothing for test strips or insulin through Cigna with my university employer (other than what they deduct from my pat of course).
My pay
Medicare Part B and my Medicare Supplement plan pay 100% of the cost of my Novolog for my DME insulin pump.
Please read Ahh Life’s comment. I live in Washington State. The legislature recently passed a law regulating insulin costs. Even my cheapest Kaiser Permanente Medicare plan cannot charge more than $35 per vial of insulin. This applies to brand name glargine (Lantus) and brand name lispro (Novolog); no other types or brands are available as far as I know from KP. Each vial is GMO engineered to effectively last 28 days; but I’ve used them longer than that at my own risk. I can order a 90 day supply of each. Infusion sets for insulin pumps are unregulated as far as I know.
we don’t have a deductible for prescriptions, you pay the same all year. $30 month
I do not have a deductible on my prescriptions. I pay $80 for 3 months of insulin.
We get all of our supplies through mail, 90 day supply. It costs $10 for 3 months, regardless of how many vials (his insulin needs have changed since he honeymooned for so long).
I don’t think I have a prescription deductible. I pay $35/90 days for Humalog through Walgreens. I only found out I could get 90 days in a retail store this summer. Prior to that I was going monthly and paying $30 each month!
I don’t have a deductible with the Medicare advantage plan I am on. Insulin RX is $35.00 per monthly Novolog refill. My endocrine provider gives me sample pens of long & short acting insulin to use in the rare instances when I am off the pump.