OurSeniors.Net strives to be your go-to source for news about senior living in Florida, your number one “for seniors magazine.” We like to bring both useful information and news of special interest to OurSeniors. The recent announcements about reductions in costs for insulin fits the bill.
If you are in a Medicare Part D prescription drug plan, your out-of-pocket cost for insulin has been capped by federal law. Beginning in 2023, the cost of a one-month supply of each Part D-covered insulin will be capped at $35, and patients will not have to pay a deductible for insulin. Seniors charged more than $35 for a month’s supply of a covered Part D insulin product can request reimbursement from their Part D plan within 30 days.
But what about people who are not covered by a Part D Plan? There is more good news if you are not yet Medicare eligible! Eli Lilly, a major provider of diabetic medications, has announced a $35 max out-of-pocket monthly cost for people with commercial insurance at most retail pharmacies. Together with the Part D price cap, these measures will make this life-saving drug affordable for many more seniors.
Here are some useful links with information about this opportunity-
For Help finding a pharmacy that participates in the Eli Lilly cost–capping program, go to the Lilly Insulin Value Program | Lilly Insulin Affordability. This offers help for people not yet eligible for Medicare coverage.
For help with Medicare Part D programs (or Medicare in general), use the Florida Department of Elder Affairs SHINE (Serving Health Insurance Needs of Elders) program. If you are not in the state of Florida, you may find a local program by using the SHIP (State Health Insurance Assistance Program) locator.
For information about helping to pay for diabetes care, go to the National Institute of Diabetes and Digestive and Kidney Diseases website.
For general information about diabetes go to the American Diabetes Association website.
Diabetes is one of the greatest threats to OurSeniors’ health. It is a devastating disease that affects multiple body systems, producing blindness, amputations, heart attacks and other complications. Like other chronic diseases, diabetes occurs more commonly as people age. The Centers for Disease Control says that about 25 percent of Americans age 65 and older are diabetic. This means that about 12 million seniors have the condition.
The cost of insulin has varied widely, depending on the type used and the frequency of administration. In the past, seniors who had Medicare Part D prescription coverage paid an average of $54 out-of-pocket for each insulin refill (in 2020 according to the Kaiser Family Foundation, a non-profit that focuses on health issues.) Spending on some types of insulin can be much higher. In 2018, the average U.S. price across all types of insulin was $98.70, compared with $6.94 in Australia, $12.00 in Canada, or $7.52 in the U.K. Florida is one of the states with the highest number of these patients.
The exact number of American seniors who take insulin is not known, but according to the American Diabetes Association, there are approximately 34.2 million Americans with diabetes. Of those with diabetes, about 7.3 million use insulin to manage their blood sugar levels. Many of those diabetics are seniors who can often ill-afford high drug prices. These cost-capping actions are very good news for seniors.
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