Insulin saves lives. That’s why we’re ﬁghting to make it more aﬀordable. Through tireless advocacy and powerful partnerships with health organizations and insulin manufacturers, we’re breaking down barriers to aﬀordable care. Together, we can ensure all of the 8.4 million Americans who rely on insulin can access and aﬀord it. Join us.
Stay up-to-date on the latest developments in the fight for affordable insulin. Below is information about out-of-pocket caps and how you can take advantage of the new cost-sharing limits based on the type of health insurance coverage you have.
Medicare is the federal health insurance program for people 65 or older. You may be eligible to get Medicare earlier if you have a disability, end-stage renal disease (ESRD), or amyotrophic lateral sclerosis (ALS). For information about Medicare eligibility, please visit Medicare.gov.
Beginning July 1, 2023, insulin covered under Medicare Part B including insulin delivered through a traditional pump that is covered under the durable medical equipment benefit will also be capped at $35 per month.
As a result of the Senior Savings Pilot and subsequently the Inflation Reduction Act of 2022, Medicare Part D enrollees monthly cost sharing for insulin is capped at $35. A covered insulin product is one that is included on a Medicare Part D plan formulary.
For more information about recent changes to insulin out-of-pocket cost-sharing under Medicare, see these frequently asked questions from the U.S. Centers for Medicare and Medicaid Services (CMS).
Medicaid is a joint state and federally funded health insurance program that provides health coverage to certain lower income individuals and families, including children, parents, people who are pregnant, elderly people, and people with disabilities. For information about Medicaid eligibility, please visit Medicaid.gov.
Most Medicaid enrollees receive insulin for free or at a significantly reduced cost. However, each state makes its own determination about which diabetes medications and supplies are covered through its Medicaid program. For more information about what medications and supplies are covered in your state, please contact your state Medicaid agency.
Approximately half of all states and the District of Columbia have enacted legislation that caps co-payments on monthly insulin and some also limit cost sharing for supplies. There are additional states considering legislation to cap monthly insulin costs, so check back regularly.
Check with your insurance company to understand which insulins are covered and the expected co-pay for each. Some manufacturers offer co-pay assistance programs to help reduce your out-of-pocket cost.
Insulin manufacturers provide insulin at no cost through their patient assistance programs to people who are uninsured and meet income eligibility requirements.
As of March 1, 2023: Lilly is expanding its Insulin Value Program that caps out-of-pocket insulin costs for legal U.S. residents to $35 or less per month. Whether you have commercial insurance or no insurance, you can fill your monthly prescription of Lilly insulin for $35 or less.
Free insulin options from Lilly:
You can learn more about Lilly’s insulin affordability solutions at InsulinAffordability.com.
March 14, 2023 announcement: Novo Nordisk announced that it would reduce the wholesale list prices for several types of insulin, effective Jan. 1, 2024. This includes:
The ADA is gathering more information about what the experience will be for consumers beginning in 2024 and will provide more details as they become available.
Patient Assistance Program (PAP): This program has been enhanced to provide insulin free of charge for 90 days to eligible participants. Effective April 1, 2020, Medicare patients were no longer required to pay $1,000 for medicines before being eligible for the Novo Nordisk PAP. To be eligible, a person must:
My$99Insulin: For $99, people with diabetes can get up to three vials or two packs of FlexPen®/FlexTouch®/PenFill® pens, of any combination of Novo Nordisk Inc. insulins with a prescription.
Follow-on brand (also known as authorized generics) insulins: Follow-on brand versions of NovoLog® and NovoLog® Mix, from Novo Nordisk Pharma, Inc. (NNPI), a Novo Nordisk A/S US company, can be ordered at one's local pharmacy, and cost 50 percent off the current list prices of the branded medicines.
Immediate Supply: A short-term, immediate-need program for those at risk of rationing while working to identify a longer-term solution. Novo Nordisk may be able to help by providing a free, one-time, immediate supply of up to three vials or two packs of pens of Novo Nordisk Inc. insulin with a prescription.
Novo Nordisk human insulin, named ReliOn™, available at Walmart for about $25/vial and for about $44/box of FlexPen®. Similar offerings are found at CVS and other national pharmacies.
Copay Savings Cards to help defray the costs for commercially insured patients who are experiencing high out-of-pocket costs. If you have insurance through your employer or private insurance, you may pay as little as $5 per 30-day supply of Tresiba® (maximum savings of $150 per 30-day supply) and/or $25 per 30-day supply of Novolog® (maximum savings up to $100 per 30-day supply) for up to 24 months.
For more information about Novo Nordisk insulins and affordability programs visit MyNovoInsulin.com.
Sanofi Patient Connection: Qualified low- and middle-income patients may receive free medication through Sanofi Patient Connection (SPC) Patient Assistance Program (PAP). Additionally, patients who have already applied to Sanofi Patient Connection (SPC) Patient Assistance Program (PAP) and have an urgent need for medication can call 1-888-847-4877 and request a one-time 30-day supply of medication at no cost via the Sanofi Temporary Access Program.
For information on Sanofi Patient Connection, visit www.sanofipatientconnection.com.
Insulins Valyou Savings Program: Eligible, uninsured patients, regardless of income level, can access one or multiple Sanofi insulins (Lantus/Insulin Glargine U-100, Toujeo, Admelog, and Apidra) for a fixed price of $35 per month.
Co-pay Assistance Programs: Eligible, commercially insured patients, regardless of income level, can use a co-pay card, which limits out-of-pocket expenses for a majority of patients to $35. These programs exist for Adlyxin, Apidra, Lantus/Insulin Glargine, Toujeo, and Soliqua 100/33.
For information on the Sanofi Insulins Valyou Savings Program or the Sanofi Co-pay Assistance Programs, visit www.teamingupfordiabetes.com.