Are you a Medicare beneficiary with diabetes using insulin?

Well, there’s good news regarding insulin copay costs. As you know, insulin is often a critical component to safely managing diabetes. Unfortunately, for some, the cost can be a significant barrier. However, the Centers for Medicare & Medicaid Services (CMS) has good news for persons who have insulin-dependent diabetes.

The Insulin Savings Program

Through the Insulin Savings Program, CMS is allowing Part D sponsors (like Medicare Advantage plans) to offer predictable copays throughout the different stages of coverage. For example, here in Snohomish County, Medicare Advantage members enrolled in an eligible plan can plan to pay $30 or less each month for their qualifying insulin.*

Check to see if your 2021 plan choice offers insulin savings.

You can see which Medicare Advantage plans and stand-alone prescription drug plans are participating in the Part D Senior Savings Model on the Medicare Plan Finder. CMS has added a new “Insulin Savings” filter to easily see which plans offer capped out-of-pocket costs for insulin. Hurry! The Annual Election Period ends December 7. If you’ve already selected a plan for 2021 but find you could save more on insulin—there’s still time to make a change.

At The Everett Clinic, we accept Original Medicare as well as select Medicare Advantage plans:

• Humana Medicare Advantage HMO, DSNP
• Kaiser Permanente Medicare Advantage HMO**
• Premera Blue Cross Medicare Advantage HMO
• Regence Medicare Advantage HMO & PPO
• UnitedHealthcare Medicare Advantage HMO, PPO, DSNP, ISNP

All of these carriers offer plans which feature insulin savings, so make sure you take advantage of this new offer.

For help, you can visit Medicare.gov 24 hours a day, 7 days a week or call 1-800-MEDICARE. You can contact the health plans directly. Or you can meet with a licensed insurance agent for one-on-one help comparing your options.

The Everett Clinic partners with the following local insurance agencies:

Additional information: CMS Insulin Savings Program Common Questions & Answers

*Plan benefits vary. Additional Medicare Advantage Plans and Prescription Drug Plans are available and may provide comparable savings. **There may be exceptions to this list. See the most up to date information here.

1Source: https://innovation.cms.gov/innovation-models/part-d-savings-model

2Source: https://www.humana.com/medicare/part-d-2021/humana-premier-rx-pdp