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 roadblocks to affordable care. Together, we can ensure all of the 7.7 million Americans who rely on insulin can access and afford it. Join us.
Lee Más Sobre el Precio y la Asequibilidad de la Insulina en Español
The ADA is aware of potential shortages of certain types of insulin, and we are monitoring the situation. We are of course concerned about the impact on patients and want to ensure that those who are prescribed the medication have access to it. We hope for the quick restoration of supply. In the meantime, anyone with concerns should talk with their health care provider about available options and alternatives.
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.
With your support, the American Diabetes Association® can continue our lifesaving work to make breakthroughs in research and provide people with the resources they need to fight diabetes.