President Trump is currently announcing the public-private partnership that will allow all insulins to be priced at no more than $35 copay under Part D Medicare.
About 1750 Part D and Advantage plans will be involved in the rollout of the new policy in October. If you are on Medicare pay close attention at the next renewal.
@docslotnick
Just tuned in and missed everything but the end of this, so thanks for posting this!
Thanks for the heads up…Medicare here we come! 20 months left for me until I start enjoying the Medicare program.
Amazing. Thank you for sharing.
I’m not on MC, but would pump users switch to a Part D plan to get the lower prices, which may also include deductible before lower copay kicks in ?
Hope to hear more as the plans roll out with details.
I do not know how to interpret the legalese of the story.
Was wondering if anyone knew - is the max of $35 per month they are talking about per vial? Or for a month’s worth of insulin?
Medicare recipients who pick a drug plan offering the new insulin benefit would pay a maximum of $35 a month starting next year, a savings estimated at $446 annually.
I do not know how medicare works. Is it flat-rate for the stuff you get? Or is there like a copay per unit.
With my insurance, insulin is affordable. But I would pay more for 2 vials than I would for 1.
I think we are just going to have to wait to see how these insurance companies and/or Medicare implement this .
My guess is that, because of the political pressure involved, they will implement it to be most favorable to the recipients.
Thank u for posting this. I am on Medicare for disability and my co-pays for Novolog vials and pen refills r astronomically $$$$ until I get into the "catastrophic " stage (past the coverage gap). But then my co-pays r ZERO $ no matter how much insulin my endo prescribes.
I wonder how this will work out when the prices go down to $35/month.
There is a documentary on PBS called “Blood Sugar Rising.” it, very sadly, documents millions of Ds who cannot (currently) afford to pay for their insulin, so they try and ration it carelessly and end up dying. We r in a horrific time with insurance and pharmacutical companies.
I get my insulin through Medicare part B because I am on a pump. Walgreens files for me. Part B pays 80% and my supplement picks up the other 20%.If you are on Medicare and an insulin pump, check it out. It is the truth!
One must be on a pump for Medicare part B to pay. If a person is not on a pump and has Medicare, he/she must use the Part D Rx benefit. It all goes back to the fact that a pump is an infusion device and medicine in infusion devices (insulin or any other infused medicine) is a Part B benefit.
I know that and understand this is usually advantage due to deductibles or donut hole of part D plans. BUT new insulin pricing for medicare is not clear if it will apply to both Part B and Part D pricing, or just Part D.
A person with pump could possibly get lower cost using their Part D plan under the new changes, but it is not clear.
Right now I pay $0 with my Medicare part B paying 80% and my supplement picking up the other 20%. I don’t know if the T administration will mess with infusion device medications. That would include a lot of other medications for other illnesses administered through infusion devices—unless they single out insulin. What aggravates me is that all brands of insulin pumps with tubing is paid through Medicare B (and supplements) at 80/20%, but since Omnipod is tubeless, it needs to be billed through the Rx plan (part D). Something about that it does not fit the description of an insulin infusion pump! I’ve been on all of the pumps and choose not to have a device attached to my bra or hip, but wear it stuck to me. I pay through the nose for my pods when I’m in the donut hole ($575/90 days). Ouch! I could be on a Medtronic or T-slim for nuthin’, nada. But I hate the tubing!
Griping over!
