Insulin $35 copay in 2021
How to get your Insulin for only $35.
Do you use one of the insulins listed below?
- Admelog – $35 copay in 2021
- Apidra- $35 copay in 2021
- Basaglar- $35 copay in 2021
- Fiasp- $35 copay in 2021
- Humulin- $35 copay in 2021
- Humalog- $35 copay in 2021
- Lantus- $35 copay in 2021
- Levemir- $35 copay in 2021
- Lispro- $35 copay in 2021
- Lyumjev- $35 copay in 2021
- Novolin- $35 copay in 2021
- NovoLog- $35 copay in 2021
- Toujeo- $35 copay in 2021
- Tresiba- $35 copay in 2021
- Soliqua- $35 copay in 2021
- Xultophy- $35 copay in 2021
Then say “Good Bye” to the Donut Hole!
The opportunity to get insulin for $35 a month is a very good deal. However, this isn’t automatic and you may be stuck paying much higher copays in 2021 if you don’t have a plan that is participating in this new program.
That’s right. Not all Part D prescription drug plans will offer the $35 copay.
It is important to understand that of the 14 insurance companies that offer Medicare plans in Maine and New Hampshire, only about half are participating in this lower copay scheme. And some companies only offer it on select plans.
How to get these new Medicare savings?
This is the important part. Getting these savings is not automatic, you have to have a plan that participates.
You will need to research all the plans to find which standalone Part D prescription drug plans or Medicare Advantage plans will offer the lower costs. Start by calling your current plan and asking what your costs will be next year. If they do not say $35 then you may want to shop around for a better plan.
Would you like some help?
If you would like help searching for a new plan or just have a question, call us at (207) 370-0143 or use the button below to send an e-mail.
When can I change my plan?
Generally, the only time you can switch to another Medicare prescription drug plan is during the Annual Medicare Open Enrollment Period that begins October 15th and ends December 7th.
However, there are other times of the year you can change, depending on where you live and what plan you have. To find out if you qualify to change plans outside of the Open Enrollment window, give me a call. I am happy to help!
If you’re only paying $35 every month, who’s helping to pay the rest?
Currently, the insurance companies that offer Part D prescription drug coverage on their plans have the option to offer prescription drugs at lower copays during the donut hole coverage gap.
But the insurance companies have to pick up the costs that would normally be paid by the pharmaceutical companies. Often, they choose to pass these costs on to you, the Medicare beneficiaries in the form of much higher premiums.
This new program makes two significant changes:
- Pharma companies (specifically, Eli Lilly, Novo Nordisk, and Sanofi as the participating insulin makers) can continue paying their full coverage gap discount for products, even if a Part D plan offers lower cost-sharing.
- Participating Part C and Part D plans will be required to cap insulin costs at $35 for a month’s supply, by applying the manufacturer rebates. This will happen year-round, even if you enter the “donut hole.“
How long will this program last?
This is a pilot program, in a sense. Medicare says it will watch how this works starting in 2021 and determine whether any changes are needed as time goes on. Expectations are from 3 to 5 years.
Medicare Administrator Seema Verma also said during the announcement: “If it goes well, we’ll extend this to other drugs. We’re starting with insulin, but depending on the progress, we will consider offering this flexibility to manufacturers and plans with other drugs, depending on the results. We think this creates a foundation and a platform to fix some of the problems that we have in Medicare Part D.”
The good news is that if Medicare does decide to continue with this low-cost insulin, other insurance companies may sign on in 2022 or later.
Would you like more info?
If you would like to talk about this program or schedule a meeting, you can reach me at 207-370-0143 or use my simple form on the CONTACT ME page of this site to send an email message.
The best part about working with me is that it w not cost you anything to discuss your options or to review the plans that are available. I am paid by the insurance companies in the form of a commission if you enroll in a plan, just like your car insurance agent.
You will not pay any more than anyone else and you are under no obligation whatsoever to enroll in any plans if you meet with me. My goal is to help you and I have found great joy in being able to offer my services to people who need my help.
If you are diabetic and using insulin,
you may be able to save a lot of money.
Call me today and I will be happy to explain all your options and help you compare plans so you can choose the coverage you need for a price you can afford.
Schedule a quick phone call today.
I can answer all your questions over the phone and I can help you with everything you need to know. I have all the forms and applications you need and I can also help you complete them.