An estimated 1.5 million Medicare beneficiaries who used insulin in 2020 would have saved $27 million with the $35 monthly cap on insulin costs. Learn about Medigap drug coverage.
Medigap Drug Coverage FAQs
Medigap and Medicare Prescription Drug Coverage
Since today’s Medicare Supplement (Medigap) plans, do not include prescription drug coverage (except insulin ), you may need a separate Medicare Part D plan. If you delay purchasing a Part D drug plan, you could incur monthly late enrollment penalties.
Future Medigap Drug Coverage
Effective in 2026 , Medicare will be able to negotiate the price directly with drug manufacturers on the following brand-name Part B (Medigap) and Part D drugs:
Eliquis
Jardiance
Xarelto
Januvia
Farxiga
Entresto
Enbrel
Imbruvica
Stelara
Fiasp; Fiasp FlexTouch; Fiasp PenFill; NovoLog; NovoLog FlexPen; NovoLog PenFill
Furthermore, Medicare will select and negotiate costs on additional Part B and Part D drugs, including:
15 Part D drugs in 2025
15 Part B and Part D drugs in 2026
20 Part B and Part D drugs in 2027
20 Part B and Part D drugs in 2028 and every year after
Medigap Plans That Cover Insulin Costs
Effective January 1, 2023 , beneficiaries with Medicare Part B and a Medigap plan that pays Part B coinsurance now cover the $35 (or less) cost of insulin with an insulin pump . Furthermore, you don’t have to pay the Part B deductible for insulin. However, Part B does not cover insulin pens or insulin related supplies including:
Syringes
Needles
Alcohol swabs
Gauze
All Medicare Supplement plans cover 100% of Part B coinsurance except Plan K (50%) and Plan L (75%). To shop Medigap plans, call Senior Healthcare Direct at 1-833-463-3262 and speak with a licensed agent. You can also get a quote.
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