This fall, it’s important to remember that open enrollment for health insurance is right around the corner. For those of you on Medicare, beginning October 15 through December 7, you can make critical changes to your health insurance to ensure you’re receiving the best coverage at the best price.
For people with type 1 diabetes (T1D) on Medicare reviewing your options is even more critical this year. Be sure to sign up for a Part D plan that will cap your insulin costs at $35/month. Across the country, there are more than 2000 plans being offered that charge no more than $35/month for each insulin prescription, with many charging even less than that.
Note that not every plan will offer this benefit, so be sure to find a plan that does and sign up for the benefit before open enrollment ends. When reviewing your options, make sure to include insulin and any other drugs taken on the drug list to see plans that offer $35/month insulin.
Some important specifics to keep in mind:
- If you choose a Part D plan with this benefit you will pay $35 per each 30-day supply of a covered insulin prescription until you reach the catastrophic coverage phase, during which you will pay 5% co-insurance. Insulins covered by participating plans will not be subject to the deductible or donut hole phases of Part D coverage.
- If you use a tubed pump, your insulin is NOT part of the $35 cap program. Your copay will remain at 20% of the cost of insulin, or whatever cost sharing you have under your Medigap plan.
- If you’re newly enrolled in Medicare or need a refresher, check out our Medicare Guide. Browsing of Medicare Part D plans will be available on October 1, and is available here. For a step-by-step guide to enrolling in Medicare, visit here.
For a comprehensive look at T1D and insurance, you can visit our insurance guide at jdrf.org/insurance, also accessible in Spanish here.
