coverage, insulin, medicare

Does Medicare Part D Pay for Insulin?

Medicare Part D is a standalone prescription drug plan for Medicare enrollees. To enroll in Part D, you must be enrolled in either Medicare Part A or Part B. 

Every Part D plan has a formulary that contains the list of covered prescription medications. The drugs covered in prescription drug plans are divided into different tiers, which include generic and brand name medications. Part D will always cover the various prescription medications that belong in categories such as anticonvulsants, antipsychotics, immunosuppressants, anticancer, antiretrovirals, and antidepressants. 

But will Part D cover insulin? Well, that ultimately depends on the equipment needed and how the insulin is given.

Medicare Part D and Insulin Coverage

Medicare Part D plans are required to cover injectable insulin. However, external insulin pumps may be covered under Medicare Part B if they are prescribed by a doctor. Medicare Part D coverage includes insulin pens, syringes, needles, alcohol swabs, and gauze. 

Now, suppose you want to enroll in a Medicare Advantage plan. In that case, you can enroll in an Advantage plan that includes Part D coverage, but before you make a decision, make sure that the insulin prescribed by your doctor will be covered.

You can also get assistance from the Part D Extra Help Program. If you have full benefits from Extra Help, your copayment for insulin will be lower than usual.

What About Part B?

If you are also enrolled in Part B, you can get coverage for:

  • Blood sugar test strips and monitors
  • Lancets
  • Glucose control solutions
  • Screenings
  • Foot exams and therapeutic shoes
  • Nutrition therapy

Medicare Part B will also only cover insulin if it’s used with an external pump.

For more information about insulin coverage through the different parts of Medicare, reach out to Temmen Insurance today. We specialize in Medicare and simplify the process by making suggestions based on your needs.

Give us a call today at (417) 633-7200 to learn more about your Medicare options!

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