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  • Writer's pictureSalisa Westrick

$35 copay for Part D-covered insulin for Medicare beneficiaries

As you may be aware, the Inflation Reduction Act limits monthly cost sharing for Part D cov

ered insulin products to no more than $35 for Medicare beneficiaries (per insulin). You may also see that in reality this copay isn't reflected in all Part D plans as of yet. Part D plans have until the end of March to update their systems to reflect the $35 cap. As such, beneficiaries may have to pay higher price for now and get reimburse with the plan for any amount above the cap. Please let the patient know that a Medicare Part D prescription drug plan must reimburse the person with Medicare within 30 calendar days for any cost-sharing amount the person is charged that exceeds $35. See more at https://www.cms.gov/files/document/frequently-asked-questions-medicare-part-d-insulin-benefit.pdf




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