Good News for Diabetes Patients

Posted by Derek Hanes
Estimated Reading Time 1 minute 11 seconds

Healthcare is a common cause for debate in the US, with all of us hoping for lower prices and improved access to medical services. But for people living with diabetes, the price of insulin has often been a scary challenge to their quality of life. Vital to controlling blood sugar and keeping many diabetes patients healthy, insulin needs to be available to all who need it.

For many retirees who count on Medicare and a Part D prescription plan, the price of insulin has historically triggered frustration. Luckily, the Inflation Reduction Act of 2022 included provisions for Medicare patients who desperately needed regulation on the price of this vital medical product.

Beginning this year, the copayment for insulin has been capped at $35 for a 30-day supply of any covered product. Even for those who have yet to meet their Part D deductible for the year, prices will now remain stable and low.

And, beginning July 1, those who receive their insulin through a pump (falling under the Part B durable medical equipment benefit) will also see their copayments for insulin lowered to $35 with no deductible.

The law also phases in changes to drug prices, by allowing Medicare plan administrators to negotiate directly with pharmaceutical companies. Beginning in 2026, new negotiated prices will take effect, and insulin prices could drop again. Those copayments will be set at either $35 dollars or 25 percent of the negotiated price, whichever is less. Other drugs will also be subject to these new standard rates.

Hopefully, this news comes as some relief to those of you living with diabetes. But if you have any concerns about your out-of-pocket medical spending, please contact us, we are licensed agents, and we’ll review your Medicare plan(s).