Insulin Cost and Affordability

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Insulin Cost and Affordability

Leading the Fight for Insulin Affordability

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.

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Find Resources to Lower Your Insulin Costs

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

65 or older

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.
Medicare.gov

Insulin covered under Medicare Part D

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.

Insulin covered under Medicare Part B

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.

Insulin out-of-pocket cost-sharing

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).
Frequently Asked Questions (Download PDF)

MEDICAID

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.
Medicaid
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.
Medicaid agency

PRIVATE/COMMERCIAL INSURANCE

State regulated health insurance plans

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.
State Insulin Copay Caps

Other private insurance coverage

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.

UNINSURED

Patient assistance programs

Insulin manufacturers provide insulin at no cost through their patient assistance programs to people who are uninsured and meet income eligibility requirements.

UPDATED BENEFITS

Lilly

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.

  • For commercially insured patients who fill at a participating pharmacy, you do not need to do anything. Lilly is automatically capping out-of-pocket costs at $35 for their insulins at participating pharmacies. Some pharmacies may not participate, so if that is the case at your pharmacy, visit InsulinAffordability.com to immediately download a co-pay Insulin Value Program savings card to receive Lilly insulins for $35 per month or you can call the Eli Lilly Solutions Center at 833-808-1234. Make sure you indicate that you have insurance as the codes for insured and uninsured patients are different.
  • If you do not have insurance and are a legal U.S. resident, visit InsulinAffordability.com to immediately download a co-pay Insulin Value Program savings card to receive Lilly insulins for $35 per month or you can call the Eli Lilly Solutions Center at 833-808-1234. Take that digital or printed card to your local pharmacy. When requesting the card, make sure you indicate you are an uninsured/cash payer as the codes for insured and uninsured patients are different.

Free insulin options from Lilly:

  • Donated insulin: Donated Lilly insulins are stocked at nearly 350 free clinics nationwide.
  • Lilly Cares Foundation: A separate non-profit organization that provides free Lilly insulin for eligible patients. Learn more about eligibility criteria at www.lillycares.com.

You can learn more about Lilly’s insulin affordability solutions at InsulinAffordability.com.

Novo Nordisk

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:

  • Reducing the list price of NovoLog® and NovoLog® Mix 70/30 by 75% off the current list price.
  • Reducing the list price of Novolin® and Levemir® by 65% off the current list price.
  • The list price of the unbranded insulins (pre-filled pens and vials and pre-mix insulins) to match the lowered price of each respective branded insulin.

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:

  • Be a U.S. citizen or legal resident.
  • Have a total household income at or below 400% of the federal poverty level (FPL). See NeedyMeds for a list of the current FPL guidelines. A family of four with an annual income up to $104,800 may receive free medications through Novo Nordisk's PAP. For individuals, the annual income limit for participation is $51,040.
  • Be uninsured, or in the Medicare program.
  • Not be enrolled in or qualify for any other federal, state or government program such as Medicaid, Low Income Subsidy, or Veterans (VA) Benefits.
  • Exceptions include patients who are Medicaid eligible who have applied for and been denied Medicaid.

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 Cardsto 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

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.

Join Us in the Fight for Affordable Insulin!

Your support and voice matter in making insulin more affordable. There are two ways to join us:
Become an Advocate
Donate to the ADA