Making Insulin More Affordable for People with Medicare More than 3.3 million people with Medicare use one or more of the common forms of insulin every day. Unfortunately, the cost of insulin has nearly tripled over the past ten years, from about $100 to $300 a vial, and out-of-pocket costs for the drug for people with Medicare can significantly fluctuate from month to month, making budgeting and management of a person’s diabetes more difficult. Starting October 15, 2020, people with Medicare will be able to enroll in a Medicare drug plan that offers insulin for no more than a $35 copay for a month’s supply. Coverage will begin on January 1, 2021. While all plans that are participating in Medicare’s new “insulin savings model” guarantee that your cost-sharing is capped at $35 for a month’s supply of insulin, some plans may offer even lower copays. Participating plans cover different types and brands of insulin, and it’s important to check each plan’s formulary to find out your exact cost, starting in the deductible phase, and going through the initial coverage, and coverage gap phases of your Medicare drug benefit. By enrolling in a participating plan, people with Medicare may save hundreds of dollars per year on your out-of-pocket costs for insulin, and you’ll always know exactly what you’ll be paying each
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As you begin to educate your residents regarding the open enrollment period to review and select their Part D plans, Partner Care Pharmacy has useful tools to share. Also, Starting October 15, 2020 Medicare beneficiaries will be able to enroll in a Medicare drug plan that offers insulin for no more than $35 copay per month. For those residents currently on insulin therapies it is important to review that coverage. Go to this website Medicare.gov/plan-compare to log-in and compare Part D plans. Have your list of medications available before you log-in. Click the links below for Medicare Part D resources Open Enrollment Video Medicare Open Enrollment flyer – English Medicare Open Enrollment flyer – Spanish 2021 Insulin Saving Model – FAQ
6 ways to lower your coverage gap costs Consider switching to generics or other lower-cost drugs. Talk to your doctor to find out if there are generic or less-expensive brand-name drugs that would work just as well as the ones you’re taking now. You might also be able to save money by using mail-order pharmacies. Find health & drug plans. Choose a plan that offers additional coverage during the gap. There are plans that offer additional coverage during the coverage gap (Medicare prescription drug coverage), like for generic drugs. However, plans with additional gap coverage may charge a higher monthly premium. Check with the drug plan first to see if your drugs would be covered during the gap. Find health & drug plans. Pharmaceutical Assistance Programs. Some pharmaceutical companies offer help for people enrolled in Medicare Part D. Find out whether there’s a Pharmaceutical Assistance Program for the drugs you take. State Pharmaceutical Assistance Programs. Many states and the U.S. Virgin Islands offer help paying drug plan premiums and/or other drug costs. Find out if your state has a State Pharmaceutical Assistance Program. Apply for Extra Help. Medicare and Social Security have a program for people with limited income and resources that helps you pay for your prescription drugs. If you qualify, you could pay no more than $3.30 for each
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