Beginning in 2023, limits copayments to $35 per month per prescription for covered insulin products in Medicare Part D plans and for insulin furnished through durable medical equipment under Medicare Part B, with no deductible.

For 2026 and beyond, limits monthly Part D copayments for insulin to the lesser of:

  • $35
  • 25% of the maximum fair price (in cases where the insulin product has been selected for negotiation)
  • 25% of the negotiated price in Part D plans

Please call your Total Benefit Solutions Medicare health insurance specialists with any questions or concerns at (215)355-2121.