Did you know that there is a Medicare Part D Senior Savings Program that can make insulin much more affordable? This insulin savings program was created for the over 3 million Medicare recipients who use insulin. This Part D coverage is available through certain Medicare Advantage Plans.

Certain plans participating in the Insulin Discount program offer a maximum copayment of only $35 a month for various types of insulin. This covers injectable insulin without the use of a pump. Unlike regular Medicare coverage, it also includes the supplies required to inject insulin such as syringes, alcohol swabs, and gauze.

Are All Plans Included in the Part D Senior Savings Model?

Almost all Part D plans can participate in the Senior Savings model. This includes Medicare Part D Prescription Drug Plans (PDPs) and Medicare Advantage Prescription Drug Plans (MA-PDs). Either of these plans that offer enhanced alternative Part D coverage is included.

The following plans are not eligible for the Insulin Savings Program.

  • Private Fee-For-Service plans (PFFS)
  • Employer/Union Direct Contract Plans
  • Section 1876 Cost Contract Plans
  • Section 1833 Health Care Prepayment Plans
  • (PACE) Program of All-Inclusive Care for the Elderly
  • Dual-Eligible Special Needs Plans (D-SNPs)
  • Religious/Fraternal Benefit Plans

Are you turning 65 and living in Boca Raton? Looking for ways to reduce your insulin expenses in Port St. Lucie or Greenacres? Call us at (561) 420-0280 or click here to learn more. We help our clients in Palm Beach County and the Treasure Coast get signed up for Medicare and obtain the affordable healthcare coverage they deserve.

Is There a Limit to the Amount of Insulin Eligible for the Maximum $35 Copay Plan?

The maximum $35 copayment is applied to one month’s supply of insulin. Those limits are set by the physician’s prescription itself. There are plan rules on drug dosage that limit the monthly amounts to ensure the safety of the patient. If someone takes multiple types of insulin each month, each prescription would be eligible for the maximum $35 copay, not all combined.

How Long Will the Insulin Savings Program Last?

The Centers for Medicare and Medicaid Services (CMS) created the Part D Senior Savings Model. Their goal is to determine if the program can lower costs while also improving health care quality. Since CMS is initially testing the program, there is a set period of eligibility. The program began in January 2021 and extends through the end of December 2025. Participating plans may change annually while the program is being tested.

Absolute Best Insurance Will Help You Choose the Right Medicare Plan.

Don’t go through the process alone, let one of our agents help you navigate the application process at no additional charge. We look for more than just an insulin discount, we make sure you get the complete coverage that takes care of every health care need. Call Absolute Best Insurance in Greenacres, Port St. Lucie, and Boca Raton at (561) 420-0280 or click here.