Is insulin a part B or Part D drug?

Asked by: Gonzalo Rosenbaum  |  Last update: October 12, 2023
Score: 5/5 (30 votes)

Medicare Part D covers injectable insulin that's not used with an insulin pump. It also covers certain medical supplies used to inject insulin, such as syringes, gauze, and alcohol swabs.

Is insulin covered by Part B?

Part B covers certain doctors' services, outpatient care, medical supplies, and preventive services. 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.

What are Part B and Part D drugs?

In general, Medicare Part B covers medical care while Medicare Part D covers most prescription drugs. However, there are times when you will need to use your Part B medical coverage for certain types of prescriptions and pharmacy-related items.

Are diabetic supplies covered under Part D?

Diabetes At-a-Glance

Generally, Part B covers services that may affect people with diabetes. Part B also covers some preventive services for people who are at risk for diabetes. You must have Part B to get the services and supplies that Part B covers. Part D covers diabetes supplies used to deliver doses of insulin.

What diabetic supplies are covered under Part B?

Diabetes supplies and services covered by Medicare Part B
  • Blood glucose testing supplies and equipment (meters, test strips, lancets and control solutions)
  • Insulin pumps and insulin used with a pump.
  • Diabetes self-management training.
  • Medical nutrition therapy, including diet and lifestyle counseling.

Medicare Explained - Part D (2023)

33 related questions found

Is insulin only covered by Medicare B if it is medically necessary and?

If you're medically required to receive insulin via an insulin infusion pump, Medicare Part B covers the cost of the insulin. You pay 20% of the Medicare-approved amount (the amount payable to a doctor or supplier that accepts Medicare) after you meet the Part B deductible.

What does Part B not cover?

Generally, most vision, dental and hearing services are not covered by Medicare Parts A and B. Other services not covered by Medicare Parts A and B include: Routine foot care. Cosmetic surgery.

Does Part D cover insulin pens?

at a maximum copayment of $35 for a 30-day supply. Some diabetic supplies that Medicare Part D may help cover include: Syringes. Insulin pens with or without included insulin.

Is Ozempic covered under Part D?

Because it's an outpatient prescription drug, Ozempic falls under Medicare Part D. Original Medicare (Part A and/or Part B) won't cover it. Ozempic is No. 10 for the highest total Medicare Part D spending in 2021, according to data from the Centers for Medicare & Medicaid Services (CMS).

Is metformin covered by Medicare?

Generic metformin is covered by most Medicare and insurance plans, but some pharmacy coupons or cash prices may be lower.

What drugs are excluded from Part D plans?

  • Drugs used to treat anorexia, weight loss, or weight gain. ...
  • Fertility drugs.
  • Drugs used for cosmetic purposes or hair growth. ...
  • Drugs that are only for the relief of cold or cough symptoms.
  • Drugs used to treat erectile dysfunction.
  • Prescription vitamins and minerals (except prenatal vitamins and fluoride preparations)

What are considered Part B drugs?

Which drugs does Part B cover? Usually, Part B covers drugs that typically aren't self-administered. These drugs can be given in a doctor's office as part of their service. In a hospital outpatient department, coverage generally is limited to drugs that are given by infusion or injection.

What drugs are protected class for Part D?

Part D plans are required to cover all drugs in six so-called “protected” classes: immunosuppressants, antidepressants, antipsychotics, anticonvulsants, antiretrovirals, and antineoplastics.

Do patients pay for insulin?

If you take diabetes medicine, you're entitled to free prescriptions for all your medicines.

Is insurance required to cover insulin?

If your health plan covers prescription drugs, it must cover the following diabetes drugs: Insulin. Other prescription drugs to treat diabetes.

Is insulin for diabetes free?

Insulin manufacturers provide insulin at no cost through their patient assistance programs to people who are uninsured and meet income eligibility requirements. For more information about manufacturer patient assistance programs, visit

Why won't insurance pay for Ozempic?

Did You Receive an Ozempic Health Insurance Denial? Perhaps We Can Help. Although Ozempic was FDA-approved in 2017 to treat adults with type 2 diabetes, some physicians prescribe it to obese or overweight individuals for weight loss. But health insurance companies often deny Ozempic, in part because it is expensive.

Does Part D cover weight loss drugs?

A 2003 law prohibits Medicare Part D from covering weight loss drugs, but if that changes, this class of popular medications could cost Medicare tens of billions, the KFF reported May 18.

Why will my insurance not pay for Ozempic?

Insurers make decisions, based on both clinical benefit and cost, about whether to cover different drugs, what restrictions to place on that coverage, and how much patients have to pay for them out of pocket. So far, drugs like Wegovy and Ozempic are usually excluded from people's insurance coverage.

What is the new insulin law for 2023?

WASHINGTON – Sens. John Kennedy (R-La.) and Raphael Warnock (D-Ga.) today introduced the bipartisan Affordable Insulin Now Act of 2023 to cap the price of insulin for all patients, including those who are uninsured, at $35 for a 30-day supply.

What covers insulin?

Part D prescription drug plans cover insulin that you inject yourself or use with a disposable insulin pump. In 2022, more than 2,100 Part D and Medicare Advantage plans participated in a program to provide insulin with no more than a $35 copayment for each month's supply.

How to get insulin for $35?

Through the Lilly Insulin Value Program, all Lilly insulins are available for $35 a month whether you have commercial insurance or no insurance. These savings cover all Lilly insulins. Terms and conditions apply.

What costs fall under Part B?

Medicare Part B is the portion of Medicare that covers most doctor visits and other outpatient medical services. It also covers durable medical equipment and preventive services. Most people pay a premium of $164.90 per month in 2023. You might pay more if your income exceeds certain thresholds.

What is part B vs Part D coverage?

Medicare Part D pays for most at-home medications, while Medicare Part B generally pays for drugs that a person receives at a doctor's office, hospital, or infusion center. Part B also pays for additional services, such as doctor's visits and some medical procedures.

Is Part D included in Part B?

Part D is the outpatient prescription drug benefit for anyone with Medicare. You must have either Part A or Part B to be eligible for Part D. Part D is only available through private companies. Part B is the Medicare outpatient benefit.