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Medicare Part D Coverage of Insulin

Date: 02/07/23

As part of the Inflation Reduction Act passed by Congress, effective Jan. 1, 2023, Wellcare members will not pay more than $35 for a one-month supply of each insulin product they take. The insulin product must be covered by their Medicare prescription drug plan and must be dispensed by either a local or mail-order pharmacy. The $35 cap applies to all coverage phases in all Medicare plans. All members are eligible, including those who receive “Extra Help.”

 Below is a list of covered insulin products:

·       Basaglar KwikPen Pen-Injector 100 UNIT/ML

·       Fiasp 100 UNIT/ML Vial

·       Fiasp FlexTouch Pen-Injector 100 UNIT/ML

·       Fiasp PenFill 100 UNIT/ML

·       Humulin R U-500 KwikPen

·       Lantus 100 UNIT/ML Vial

·       Lantus Solostar Pen-Injector 100 UNIT/ML

·       Levemir 100 UNIT/ML Vial

·       Levemir FlexTouch Pen-Injector 100 UNIT/ML

·       NovoLIN 70/30 100 UNIT/ML Vial

·       NovoLIN 70/30 FlexPen Pen-Injector 100 UNIT/ML

·       NovoLIN N 100 UNIT/ML Vial

·       NovoLIN R 100 UNIT/ML Vial

·       NovoLIN N FlexPen Pen-Injector 100 UNIT/ML

·       NovoLIN R FlexPen Pen-Injector 100 UNIT/ML

·       NovoLOG 100 UNIT/ML Vial

·       NovoLOG FlexPen Pen-Injector 100 UNIT/ML

·       NovoLOG Mix 70/30 100 UNIT/ML Vial

·       NovoLOG Mix 70/30 FlexPen Pen-Injector 100 UNIT/ML Vial

·       NovoLOG PenFill 100 UNIT/ML

·       Soliqua Pen-Injector 100-33 UNT-MCG/ML

·       Tresiba 100 UNIT/ML Vial

·       Tresiba FlexTouch Pen-Injector 100 UNIT/ML

·       Tresiba FlexTouch Pen-Injector 200 UNIT/ML

·       Toujeo Solostar Pen-Injector 300 UNIT/ML (1 unit dial)

·       Toujeo Max Solostar Pen-Injector 300 UNIT/ML (2-unit dial)

·       Xultophy Pen-Injector 100-3.6 UNIT-MG/ML

Beneficiaries identified as overpaying will receive a refund letter inclusive of reimbursement for the cost difference. As always, we encourage you to use the resources on CMS.gov (timeline and FAQ) or to contact your Provider Services team if you have any questions or concerns.