The Kaiser Family Foundation reports that one in three people with Medicare have diabetes today, and they are paying an ever higher price for their insulin. A new Medicare initiative could save people with diabetes as much as $420 a year on their insulin.
More than 30 million adults in the US have diabetes, including nine million people over 65. Medicare Part D covers insulin. Medicare Part D also covers syringes and needles. But, people with diabetes still pay a lot out of pocket in copays and deductibles. Medicare Part B only covers insulin if you need an insulin pump, in which case you pay 20 percent of the cost.
Beginning in January 1, 2021, Medicare is making available insulin drug coverage for a maximum of $35 for a one-month supply. In order to pay this price, you must sign up for a Part D plan or Medicare Advantage plan that participates in this insulin savings model. You must also use an insulin product covered by the plan under this model.
Insulin has been around now for more than 100 years. So, you would think it would cost almost nothing. But, companies have patented devices for administering it, in order to be able to raise its price dramatically in the US. A new RAND study finds that insulin prices in the US are now more than eight times higher than in 32 high-income comparison nations combined.
In the US, the average price for insulin is around $100. But in Chile, it’s about $26, and in Turkey, it’s less than $4.00. In Canada, it’s about $18. In Japan, it’s less than $19. In Great Britain, it’s around $11.
Net prices for insulin in the US are generally a lot lower than the manufacturer prices. Drug companies issue rebates and discounts in many cases. But, even factoring those in, the price Americans pay for insulin is easily still four times higher than the average of other countries.
Prices for insulin weren’t always this high in the U.S. The price for rapid-acting insulin rose by more than 15 percent each year between 2012 and 2016. During this time, people with workplace health insurance paid literally twice as much for their insulin in 2106, $2,853 than they had in 2012, $1,432.
Whether you are enrolled in traditional Medicare or a Medicare Advantage plan, Medicare also covers a range of services and supplies for people with diabetes. Medicare covers a glucose monitor, lancets and test strips, as well as an insulin pump and insulin if you need it. Call Medicare at 1-800-633-4227 for more information. If you are enrolled in a Medicare HMO or other private Medicare plan, call the health plan.
Medicare will also sometimes cover foot care and therapeutic shoes for people with diabetes. For some people, Medicare covers diabetic self-training and education. Medicare also covers a diabetes prevention program. Talk to your doctor about these services and supplies.
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