Does Medicare Cover Insulin?

Christian Worstell
In this article...
  • Does Medicare cover insulin via Medicare Part B or D? Find out how much it costs to get a one-month supply on these Medicare plans.

Medicare is a federal health insurance program for those over the age of 65 and some people who have disabilities. If you live with diabetes, you may be asking, “Does Medicare cover insulin?” The answer is that it depends on the kind of insulin you use and the Medicare plan you have.

When Does Medicare Cover Insulin?

Medicare does cover insulin and some related supplies, but what's covered depends on your plan. 

For example, most people using Medicare Part B still pay all or most of the costs for:

  • Needles
  • Injectable insulin
  • Insulin pens
  • Syringes
  • Alcohol swabs
  • Gauze

People who have Medicare Part D pay for:

  • Insulin pump supplies

The best way to decrease your total out-of-pocket cost for insulin under Medicare is to have both Part B and Part D.

Does Medicare Part B Cover Insulin?

Medicare Part B covers insulin when it is medically necessary with the use of an insulin pump, since it is recognized as durable medical equipment in this case. That insulin is covered 80%, and you will need to pay 20% of the Medicare-approved cost unless you have a Medicare supplement plan to pick up the difference.

Does Medicare Part D Cover Insulin?

You may be able to get Medicare drug coverage that provides access to non-pump insulin at a lower cost of $35 for a 30-day supply. This is a benefit under Part D plans as of January 1, 2021.

To get the $35 insulin cost savings you need to:

The plan you choose needs to be part of the insulin savings model.

Part D plans may also help you pay for some medical supplies used to inject insulin, like alcohol swabs, gauze and syringes.

How Much Do You Pay for Insulin With Extra or Partial Extra Help?

If you receive partial Extra Help, then you could pay up to $92 and 15% coinsurance for each month of insulin you receive through your pharmacy. The amount you pay could be more or less than the insulin savings model’s $35 fee.

With full Extra Help, the copayment for insulin is less than $35 per month thanks to the Senior Savings Model.

Cal 1-800-MEDICARE if you want to know if you qualify for or receive Extra Help.

Christian Worstell
About the Author

Christian Worstell is a senior Medicare and health insurance writer with HelpAdivsor.com. He is also a licensed health insurance agent. Christian is well-known in the insurance industry for the thousands of educational articles he’s written, helping Americans better understand their health insurance and Medicare coverage.

Christian’s work as a Medicare expert has appeared in several top-tier and trade news outlets including Forbes, MarketWatch, WebMD and Yahoo! Finance.

While at HelpAdvisor, Christian has written hundreds of articles that teach Medicare beneficiaries the best practices for navigating Medicare. His articles are read by thousands of older Americans each month. By better understanding their health care coverage, readers may hopefully learn how to limit their out-of-pocket Medicare spending and access quality medical care.

Christian’s passion for his role stems from his desire to make a difference in the senior community. He strongly believes that the more beneficiaries know about their Medicare coverage, the better their overall health and wellness is as a result.

A current resident of Raleigh, Christian is a graduate of Shippensburg University with a bachelor’s degree in journalism. You can find Christian’s most recent articles in our blog.

If you’re a member of the media looking to connect with Christian, please don’t hesitate to email our public relations team at Mike@MyHelpAdvisor.com.

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