$35 Insulin List
The $35 Insulin list is a result of the 2023 Part D senior savings model. We will update the link to the list below with the most current version as it becomes available. See below to access the list and to learn details on the senior savings model and how it caps insulin costs for Medicare beneficiaries.
$35 Insulin List: Origin
Starting in January 1, 2023 Part D insulin costs will be capped at $35 for a month’s supply. This cap was a result of the Inflation Reduction Act and replaces the similar benefits of the prior insulin cap put in place by the Part D Senior Savings Model. The former model was discontinued on December 31, 2023. The new model is available to all people with Medicare prescription drug coverage. Coverage can be through Stand alone Medicare Part D plans or Part D benefits in a Medicare Advantage plan.
How the plan will work
The new savings model creates a $35 insulin list that puts a $35 per month copay cap on a number of select insulins. Insulin on the eligible list will not be subject to deductibles, copays or the donut hole. The list does not include all types of insulin however. It also does not cap a number of the new model “insulin type” medications. (called dipeptidyl peptidase-4 (DPP-4)inhibitor) Examples of medications not on the list are Jardiance, Victoza, Januvia, Trulicity and Ozempic. Medicare beneficiaries will automatically have copays reduced to $35 per month supply. There is no special action needed to have the eligible insulin capped. There are currently 5 Pharmaceutical drug manufaturers that are participating in the model $35 insulin list for 2023:
- Eli Lilly and Company
- MannKind Corporation
- Mylan Specialty L.P., a Viatris Company
- Novo Nordisk, Inc. and Novo Nordisk Pharma, Inc.
- Sanofi-Aventis U.S. LLC
$35 Insulin List: Link to the list of medications (Live link will update automatically when CMS provides them)
Medicare agents: Use Connecture, Sunfire or MyMedicarebot to see run drug list comparisons
Agents can compare all stand alone PDP and Medicare Advantage plans coverage using one of the enrollment platforms. All three will save client information and drug lists. Agents can compare total drug costs across all plans using one system. All 3 systems also provide compliant call recording at no cost to the agent.