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Medicare Insulin Costs Plummet After Biden Policy
24 Mar
Summary
- 75% of Medicare patients pay $35 or less for monthly insulin.
- Average out-of-pocket insulin costs dropped from $50 to $22.
- 25% still pay over $35 due to prescription prorating rules.
Policies implemented during the Biden administration have dramatically reduced insulin prices for Medicare patients. Research indicates that approximately 75% of Medicare prescription beneficiaries now pay $35 or less for a monthly insulin supply, a significant increase from previous years.
Average monthly out-of-pocket expenses for insulin have fallen from over $50 to around $22 between 2019 and 2023. This trend has been observed across all U.S. states, marking historically low insulin costs for individuals enrolled in Medicare.
The Inflation Reduction Act of 2022 established an out-of-pocket cap for insulin under Medicare Part D, effective January 2023. This is the first federal price cap for all Medicare beneficiaries.
Despite the positive impact, about 25% of Medicare patients continue to pay over $35 monthly. This is attributed to prescription prorating rules where non-30-day multiples can be charged up to the next full month's cap.
