Big changes will impact costs for Medicare enrollees with diabetes next year. Roughly 1,635 Medicare plans will be participating in the Senior Savings Program. Starting January 1, 2021, beneficiaries who enroll in one of these plans will have a maximum copay of $35 for a 30-day supply of insulin.
This $35 copay cap will apply during all four stages of Medicare Part D: the deductible, initial coverage, coverage gap and catastrophic phases. In other words, enrollees do not have to worry about out-of-pocket costs for insulin increasing before the deductible is paid or when they reach the “donut hole.” Diabetes is very common among Medicare enrollees, and insulin can be costly, so this is a big deal.
Through the Medicare Engine, WAP agents can access a spreadsheet that lists plans participating in this program in Arizona.
If you need information on plans outside of Arizona, use Medicare’s Plan Finder tool. Look for plans in your area and then apply the “insulin savings” filter in the top right corner of the screen. Check the box if you only want to see plans that are participating in the Senior Savings Model.
