Medicare
Medicare and diabetes: insulin costs and supplies, who pays for what
Covered insulin under Medicare drug plans has a $35 monthly cap, and insulin used in an insulin pump is covered under Part B. Other diabetes supplies are covered in different parts of Medicare, so it helps to know which is which.
Who covers what
- Insulin in pens or vials: covered by Part D drug plans, with the $35 monthly cap on covered insulin.
- Insulin pumps and the insulin used in them: generally covered by Part B as medical equipment.
- Test strips, meters and lancets: generally covered by Part B, with rules about quantity and suppliers.
- Continuous glucose monitors: covered in certain situations. Ask about the rules.
What to check in a plan
Make sure the specific insulin you use is on the plan's drug list, and ask where you can buy supplies. Some plans use particular suppliers.
Have this ready when you call
- Each insulin you use
- Your pump or monitor model
- Your supplier's name
- Your medicine list
Common questions
Does the $35 cap apply to every insulin?
It applies to insulin your plan covers. Check that the one you use is on the plan's list.
Can I change plans because of insulin costs?
During open enrollment, yes. At other times it depends on your situation.
Related answers
Rather talk it through?
Call 855-367-1095 and a licensed agent will go through your situation with you. There is no charge to ask, and no obligation to enroll.
- Licensed insurance help
- No guaranteed eligibility, pricing, or availability
- Educational starting point
GetFastRates.com is not connected with or endorsed by the U.S. government or the federal Medicare program. Calling connects you with licensed insurance help. Plan availability, costs, benefits, and enrollment rules can vary by state, carrier, and individual situation.