Best medicare part d plans for diabetics

Table of Contents Show

Signing up for Medicare
Download Medicare Checklist
Use the plan finder tool
What Is Important to Me?
The Parts of Medicare
Which Medicare Advantage plan is best for diabetics?
Does Part D Medicare pay for insulin?
How do I know which Medicare Part D plan is best?
Is GoodRx better than Medicare Part D?

Signing up for Medicare

When you live with diabetes, choosing the right Medicare plan can seem overwhelming. Throughout this process, you will need to make important decisions for your healthcare coverage to make sure you can afford the treatments you need.

Whether you're transitioning to Medicare or are looking for a better plan, we have a set of tools with important information to help you choose the best plan for your needs.

Download Medicare Checklist

Your Medicare needs will be unique. Download the checklist below to help identify different cost, coverage, and network considerations specifically for people with diabetes.

Download Medicare checklist

Download

Once you have a better understanding of what you may need in a plan, take this checklist with you as you have important conversations around choosing a plan. You can also visit Medicare’s Plan Finder to compare plans at www.Medicare.gov/find-a-plan or call 1-800-MEDICARE for more information.

Use the plan finder tool

Find the Medicare Part D plans in your area that cover your Lilly insulin for as little as $35 a month.

Find Plans

What Is Important to Me?

By prioritizing what is important to you in the following three categories, you can be more prepared to compare plans and select the one that works best for your situation.

Cost

A lower monthly premium does not always equal lower costs, especially if you are on multiple medications. Your cost is determined by monthly premiums, out-of-pocket costs, and the overall coverage you need.

Coverage

You want to be sure your medications and regular treatment procedures are covered by enrolling in a prescription drug plan. You might already have additional insurance through the military, a spouse, an employer, or a low-income subsidy. Also, many Medicare Advantage plans offer supplemental benefits such as vision, dental, and hearing coverage.

Network

Your network determines the level of access you have to certain doctors, pharmacies, and even medications. Ensure that the providers and treatments you need are in your plan’s network. If you are flexible in this area, you could see some cost advantages.

The Parts of Medicare

Part A and Part B

If you are automatically enrolled in Part A and Part B, you will get your red, white, and blue Medicare card in the mail three months before your 65th birthday. Otherwise, you will want to check with your local Social Security office to enroll by visiting www.ssa.gov or by calling 1-800-772-1213.

Part A is your hospital insurance plan.

It covers inpatient care, hospital stays, skilled nursing care, hospice care, and some home care. Most people do not have to pay a premium for Part A.

Part B is your medical insurance plan.

It will pay a portion of doctor visits, some diabetic medical supplies, and some preventive services. You will pay a premium for Part B based on your income.

Note: Many patients add a supplemental policy such as Medigap to help lower Part A and Part B costs. Medigap cannot be used for Part D coverage or in Medicare Advantage plans.

For prescription drug coverage you have two options:

Part C is your Medicare Advantage plan.

This plan consolidates Part A, Part B, and prescription drug coverage into one managed care benefit. Most Medicare Advantage plans offer additional services like vision, dental, and hearing. Medicare Advantage plans are offered by private insurance companies that are approved by Medicare. Prescription drug coverage varies by network and formulary types, so make sure the medications you need are covered before selecting a plan. Because Medicare Advantage networks may be narrower, it could lower out-of-pocket costs, but be aware that there are greater restrictions to access certain providers and treatments. You will pay a single premium through Part C that will cover Part A, Part B, and your prescription drug coverage.

Part D is your stand-alone prescription drug plan.

If you sign up for Part A and Part B under Original Medicare, you can add drug coverage through selecting a stand-alone Part D plan. This will help you pay for insulin, syringes, needles, and other outpatient prescription drugs. If you choose to have Original Medicare, you will pay a separate premium for your Part D coverage. Similar to prescription drug coverage offered through a Medicare Advantage plan, a stand-alone Part D plan will also provide coverage that varies based upon formulary type, out-of-pocket costs, and networks.

Regardless of how you choose to obtain prescription drug coverage, be mindful that your providers and treatments are covered before selecting a plan.

Download Medicare checklist

Download

This website is intended for informational purposes only and does not recommend any specific plan or path. All healthcare coverage decisions should consider present and future medical needs and are made at the sole discretion of each individual.

Which Medicare Advantage plan is best for diabetics?

Medicare Part B covers most diabetes medication and treatment, so if you're looking for supplemental insurance, you should choose a plan that covers the deductible, coinsurance, and copayment for Part B plans. For that reason, we recommend Medigap Plans C and F for diabetes coverage for anybody under the age of 65.

Does Part D Medicare pay for insulin?

NEW! Change to Medicare Part D insulin costs starting January 1, 2023. Plans can't charge you more than $35 for a one-month supply of each Medicare Part D-covered insulin you take, and can't charge you a deductible for insulin.

How do I know which Medicare Part D plan is best?

En español | Your goal in choosing a Part D plan is to select a plan that 1) covers all your drugs with the lowest out-of-pocket cost, 2) provides good service and 3) checks the box on any other personal requirements you might have.

Is GoodRx better than Medicare Part D?

GoodRx can also help you save on over-the-counter medications and vaccines. GoodRx prices are lower than your Medicare copay. In some cases — but not all — GoodRx may offer a cheaper price than what you'd pay under Medicare. You won't reach your annual deductible.