New Federal Report Shows Major Savings for Insulin Users

The U.S. Department of Health and Human Services (HHS) has issued a report crediting a new federal law that places a $35 cap on a month’s supply of insulin with significantly lowering healthcare costs for Medicare patients. The report states that if the cost of insulin were capped at this amount in 2020, 1.5 million seniors across the country would have saved an average of $500 on insulin for the year.

As part of the Inflation Reduction Act, the insulin provisions went into effect on January 1, 2023 for patients with Medicare Part D prescription drug plans, which cover insulin that you inject yourself or use with a disposable insulin pump.

Starting on July 1, 2023, beneficiary cost sharing will be limited to $35 for a month’s supply of insulin under Medicare Part B, which covers insulin that you use with a non-disposable pump through its durable medical equipment provision.

It is important to know that under the current Part D insulin model, participating plans are not required to cover all insulin products at the $35 monthly copayment amount. They must only cover one of each dosage form (vial or pen) and insulin type (rapid-acting, short-acting, intermediate-acting and long-acting).

This means insulin users might need to switch from one insulin product to another to save on their out-of-pocket costs, or switch to a plan that covers their insulin product at the $35 copayment.

The HHS report also includes findings on the critical role insulin plays in the treatment of diabetes, and how insulin affordability affects adherence to insulin treatment and long-term health outcomes. In addition, it lists savings by state and by demographic characteristics including gender, race and ethnicity, and age.

The states with the most people with Medicare projected to benefit from the new Inflation Reduction Act insulin cost savings are Texas with 114,000 beneficiaries, California with 108,000 beneficiaries and Florida with 90,000 beneficiaries.

According to the National Council on Aging, due in part to the rising costs of prescription insulin, diabetes has been the costliest chronic condition in America. Skipping doses, taking less insulin than prescribed or delaying refills can lead to extremely high blood sugar and potentially life-threatening complications.

If you have received a diabetes diagnosis, it is important to see your physician regularly and manage your health through prescribed medications, a nutrition plan and exercise. For more information on diabetes prevention, diagnosis and treatment, please visit:

Pacific Federal is a Zenith American company and subsidiary of Harbour Benefit Holdings, Inc.