Effective January 1, 2021, the part D Senior Savings Model a.k.a. Insulin Savings Program allows participating Part D plans to offer insulins at a $35 co-pay for one month supply of Insulin through all phases of coverage (Deductible, Initial Coverage, and Coverage Gap a.k.a. Donut Hole.
What plans participate in the party seen your savings model?
Insulin Savings Program‘s include Medicare Advantage Prescription Drug plans a.k.a. MAPD and Part D Prescription Drug Plans a.k.a. PDP plans that participate in the model.
Does it change of plans formulary or step therapy?
No. Your plans formulary and or staff therapy still applies. The program allows plans to offer a fixed, consistent cost-sharing on insulin.
Can people with Low-Income Subsidy (aka L.I.S. or Extra help) participate in the Part D Senior Savings Model /Insulin Savings Program?
No. Low-income Subsidy / Extra Help enrollees already have a set Part D copayment.
What is the monthly co-pay for one month’s supply of insulin?
The maximum copayment under the model is $35 for one month supply of each insulin medication which is covered on the plan’s formulary and prescribed by a doctor. This may be subject to plan rules and limited by a physician’s prescription.