Diabetes Basics
2023 – Cost of Insulin to Rise for Some – Do You Qualify for the Cap?
In the US alone, more than 8 million people need insulin to keep them well – and unfortunately it only takes missing a few doses for fatal consequences.
High priced prescriptions can lead to catastrophic amounts of debt when being used over long periods of time – even leading to bankruptcy.
Currently, 1 in 5 Medicare recipients who rely on this medicine are living dangerously because they’re struggling financially after being injected with such an expensive medication due to chronic conditions such as diabetes (14%).
In 2020, the average out-of-pocket spending for insulin averaged at $54 per prescription.
Depending on the type of insulin people use, many spent between $70 and $115.
Over 3 million people currently using Medicare spend an average of four times more annually on this drug now than they did just 15 years ago – $1.03 billion against $236 million – largely because of rising prices.
Starting in 2023, there is a cap set at no more than $35 per month (regardless if you had met your deductible or not) which is quite significant considering the high rate of usage among those who are 65 and older (over 30%!).
The bill limits insulin copays to $35 per month for Medicare Part D beneficiaries starting in 2023.
This price cap, however, only applies to individuals who are eligible for Medicare—everyone else is out of luck.
Starting in 2025, if you are covered by Medicare, your yearly out-of-pocket will be a cap will be $2,000 on Part D prescription drugs.
You don’t have to pay more – no matter what your income level may be!
It will also allow Medicare to negotiate the costs of certain prescription drugs.
