Millions of people across the United States rely on Medicare to cover their most important healthcare needs. You might do the same. More specifically, you might use your Medicare health insurance to cover some of the costs of the insulin that you use each month.

If so, there are some important changes coming that you need to be aware of. Medicare is altering how it covers certain types of insulin and related devices. Keep reading to learn more.

What is Insulin? Who Needs It?

Insulin is a hormone that our bodies naturally produce. It enables the body to use glucose to create energy. When someone has diabetes, their body fails to either use insulin properly or produce enough of it.

People with diabetes often inject insulin as a form of treatment. Doing so replaces the insulin that your body should be producing naturally but isn’t.

What Doesn’t Medicare Cover?

Let’s quickly take a look at what Medicare Part B doesn’t cover. You will need to pay out-of-pocket for the following things:

  • Gauze
  • Alcohol swabs
  • Needles
  • Syringes
  • Insulin pens
  • Insulin (unless the use of an insulin pump has been deemed medically-necessary)

How is Medicare’s Insulin Coverage Changing?

There are a few key ways in which Medicare’s coverage for insulin is changing. Let’s look at each of them individually.

New Cap Out-of-Pocket Costs

First, in 2021 Medicare began offering Part D plans that cap the out-of-pocket amount that you can pay for certain types of insulin each month at $35. To access this, you need to join a Medicare plan or a Medicare Advantage plan that participates in the savings model.

Additionally, keep in mind that Part D covers injectable insulin that’s not used with an insulin pump. If you use an external insulin pump, then you may be able to get coverage for that with your Part B insurance.

More Insulin Savings Plans to Choose From

In 2021, all Medicare enrollees will be given at least 9 different insulin savings plans to choose from. But there are a total of 1,635 different plans to choose from, so you may have many more options to consider.

This update is beneficial to Medicare recipients because it gives them more options to choose from. With the update, Medicare has made it easier to find the right insulin savings plan for your specific healthcare and budgetary needs.

Insulin Coverages Vary By Plan

When you look at insulin savings plans, you need to keep in mind that plans get to pick and choose which types of insulin they cover. So if you want to continue using a specific type of insulin, then you need to verify that the plan you’re interested in covers it before enrolling.

Your Next Steps

Keeping your insulin costs down is an important part of managing your healthcare expenses. The best way to do that is by picking the best insulin savings plan for your specific needs. But you might be wondering how to find that plan or which factors you should prioritize while looking.

If so, reach out to a partnered licensed agent through Time for 65. They’re Medicare experts who can answer all of your coverage questions. Get in touch with one today by either filling out this form or giving us a call.