Part D covers injectable insulin with either a disposable or non-traditional insulin pump. It also covers certain medical supplies used to inject insulin, like syringes, gauze, and alcohol swabs, as well as disposable pumps and some oral diabetes drugs. Covered insulin products are included in your loved one's plan formulary. Check with your loved one's insurance plan for more information.
Starting in 2024, your loved one's Medicare drug plan cannot charge more than $35 for a one-month supply (or $105 for a three-month supply) of each insulin product Part D covers, and your loved one does not have to pay a deductible. This applies to everyone who takes insulin, even if they receive Extra Help.*
Similar caps on costs apply for traditional insulin used in insulin pumps covered under Part B. If your loved one takes insulin through a traditional pump covered under the durable medical equipment benefit, that insulin is covered under Part B. Your loved one will not pay more than $35 for a one-month supply and the Medicare deductible no longer applies. Visit Medicare.gov/coverage/insulin to learn more.
Recommended adult vaccines are also available at no cost in 2024. Part D covers all recommended adult immunizations not covered by Part B, including shingles, tetanus, diphtheria, and pertussis (Tdap).
Part B covers annual flu shots, the hepatitis B series, pneumococcal (pneumonia) shots, and COVID-19 vaccine and boosters.
Saving money on prescription drugs
Starting in 2024, if your loved one's Part D drug costs are high enough to reach the catastrophic coverage phase, they don't have to pay a copayment or coinsurance.
Once out-of-pocket spending reaches $8,000, including certain payments made by other people or entities or the Extra Help program on behalf of your loved one, they won't have to pay a copayment or coinsurance for covered Part D drugs for the rest of the calendar year.
If your loved one gets Extra Help*, they won't have some of these costs.
Also, note that coinsurance amounts for some drugs covered by Part B may be less if a prescription drug's price increases higher than the rate of inflation. Your loved one's coinsurance can change depending on the drug's price. They might pay a lower coinsurance for certain drugs and biologicals covered by Part B that they get in a provider's office, pharmacy, or hospital outpatient setting if those drug prices have increased higher than the rate of inflation. The specific drugs and potential savings change every quarter.
*Extra Help is a program that helps cover Part D drug costs and will expand to cover more drug costs for certain people with limited resources and income. For more information, see Extra Help in our Benefits section and/or The Extra Help Program in our Guides section.