Medicare Part D (drugs) insulin benefits enhanced

Effective January 2023, “the cost of a one-month supply of each Part D-covered insulin is capped at $35, and you don’t have to pay a
deductible for insulin. This applies to everyone who takes insulin, even if you get Extra Help. If you get a 60- or 90-day supply of insulin, your costs can’t be more than $35 for each month’s supply of each covered insulin.”

“Plans have until the end of March 2023 to update their systems to reflect the $35 cap on insulin, which means you might be charged a higher amount during this time when you fill a prescription for insulin. If you you pay more than $35 for a month’s supply of a covered insulin product in January and/or February 2023, your plan must reimburse you within 30 calendar days for any amount you paid above the $35 cap. Contact your plan to find out how to get reimbursed.”

“If you use a covered insulin product you can add, drop, or change your Part D coverage one time between now and December 31, 2023. If you change plans mid-year, your True Out-of-Pocket (TrOOP) costs will carry over from one plan to the next. Call 1-800-MEDICARE if you take insulin and want to change your plan.”

Refer to the Medicare Part D (prescription drug coverage) Insulin website or contact Medicare (1-800-MEDICARE (1-800-633-4227) for full details.

The reference site only mentions Medicare Part D (prescription drugs). It does not mention Medicare Advantage (Part C) plans with prescription drugs. Contact Medicare (1-800-MEDICARE (1-800-633-4227) or your Medicare Advantage plan provider to ensure this change applies to you.


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