Insulin Savings Program

(Senior Savings Model)

What Is It?

A Medicare program which limits the cost for qualifying injectable insulins to $35 for a one month supply (or $105 for a 3 month supply) during the first three stages of designated Medicare Part D Prescription Drug Plans

How Are Insulins In The Program Chosen?

Insulin manufacturers may choose to participate in the program and they may also chose which insulins to designate as part of the program. Such insulins are called qualified insulins. Qualified insulins may be in vail or auto injectable pen form. Qualified insulins can also be fast acting, intermediate acting, or long lasting.
Qualifying insulins in the program can change from year to year.

What Does This Mean For Medicare Part D Prescription Drug Plans Benefits?

Part D carriers may choose which of their Prescription Drug Plans participate in the program. Carriers may also chose to have none of their Part D Plans participate, should they wish.
Should a carrier chose to have participating plan(s), the carrier will chose which qualified insulins they wish to be on their Formulary (list of covered medications). Therefore chosen qualified insulins can differ from carrier to carrier and plan to plan.
In addition, the participating plans as well as the chosen qualifying insulins can change from year to year.

Are Other Diabetic Medications Part Of The Insulin Savings Program?

No. A1C medications or other diabetic management medications are not part of the program.

I Am Enrolled In A Part D Plan Which Is Not Part Of The Program And Was Prescribed An Insulin Mid-Year. Can I Change My Part D Plan?

No. Unfortunately, being prescribed an injectable insulin or having a change in your insulin does not give you a Special Enrollment Period. You must remain in your current Plan until years end.
In the meantime, We will be happy to discuss your which insulins are on your current Part D Plan’s formulary and which may be more cost effective so you can share this information with your medical provider.
However, we do encourage you to reach out to us during the Annual Enrollment Period (10/15- 12/07) to shop your Plan.

I Am Enrolled In A Part D Plan Which Is Part Of The Program, But My Insulin Has Changed and Is Not On My Plan’s Formulary. Can I Change My Part D Plan?

No. Unfortunately, being prescribed a different injectable insulin or having a change in your insulin does not give you a Special Enrollment Period. You must remain in your current Plan until years end.
In the meantime, we will be happy to let you know which qualifying insulins your current Part D Plan has on their Formulary so you can share this information with your medical provider.
However, we do encourage you to reach out to us during the Annual Enrollment Period (10/15- 12/07) to shop your Plan.

Do I Still Need To Shop My Part D Prescription Drug Plan Each Year?

Yes. Changes do occur with the Insulin Savings Program each year such as the qualified insulins, the Part D Plans participating and each Plan’s Formulary.
It is important to know your Part D Prescription Drug Plan is not required to inform any changes including those which may affect you. Therefore, it is important to shop during the designated time to make sure your plan is still appropriate for you.

The time to shop is during the Annual Enrollment Period (10/15- 12/07). We encourage you to reach out to schedule an appointment when you receive the email reminder from us.