Starting in 2023, the cost of a one-month supply of each Part D-covered insulin will be capped at $35, and you won’t have to pay a deductible for insulin. This applies to everyone who takes insulin, even if you get Extra Help.
For insulin used with a traditional insulin pump that is covered under the Medicare durable medical equipment benefit, you pay 20% of the Medicare-Approved Amount after you meet the Part B deductible. You pay 100% for insulin-related supplies (like syringes, needles, alcohol swabs, and gauze), unless you have Part D.
Part D covers these:
- Injectable insulin that isn’t used with a traditional insulin pump
- Insulin used with a disposable insulin pump
- Certain medical supplies used to inject insulin, like syringes, gauze, and alcohol swabs
If you use an external insulin pump that isn’t disposable, Part B may cover insulin used with the pump and cover the pump itself as durable medical equipment (DME). If you live in certain areas of the country, you may have to use specific insulin pump suppliers for Medicare to pay for a durable insulin pump.
Medicare Part B (Medical Insurance) doesn’t cover these:
- Insulin (unless use of an insulin pump is medically necessary
- Insulin pens
- Alcohol swabs