Medicare Part B (Medical Insurance) covers insulin if you use an insulin pump that’s covered under Part B’s durable medical equipment benefit. Part B doesn’t cover insulin pens or insulin-related supplies like:
- Syringes
- Needles
- Alcohol swabs
- Gauze
- Injectable insulin that isn’t used with a traditional insulin pump
- Insulin used with a disposable insulin pump
- Certain medical supplies used to inject insulin, like syringes, gauze, and alcohol swabs
- Insulin that’s inhaled
Your costs in Original Medicare
- The cost of a one-month supply of each Part D- and Part B-covered insulin is capped at $35, and you don’t have to pay a deductible for insulin. If you get a 3-month supply of insulin, your costs can’t be more than $35 for each month’s supply of each covered insulin. This means you’ll generally pay no more than $105 for a 3-month supply of covered insulin.
- Under Part D, the $35 cap applies to everyone who takes insulin, even if you get Extra Help.
- If you have Part B and Medicare supplement Insurance (Medigap) that pays your Part B coinsurance, your plan should cover the $35/month (or less) cost for each covered insulin.
- For insulin-related supplies (like syringes, needles, alcohol swabs and gauze), you’ll pay 100% of the cost under Part B (unless you have Part D).