Medicare Part D insulin coverage: formulary strategies amid policy headwinds.

ABSTRACT: In recent years, multiple insulin-related policies took effect for Medicare Part D plans, including the Part D Senior Savings Model test (2021-2023) and the 2022 Inflation Reduction Act, provisions of which were implemented between 2023 and 2025. These policies created a variety of financial incentives for plans that may influence insulin formulary design in Part D, potentially affecting beneficiary access to insulin. For example, while limiting cost-sharing lowers out-of-pocket costs for beneficiaries, it may also reduce plans' ability to use tiering to steer beneficiaries toward preferred insulins. Using Part D formulary files from 2020-2025 we examined plan insulin coverage separately for Medicare Advantage Prescription Drug Plans and stand-alone Prescription Drug Plans. We found that p

SUBMITTER: Buttorff C 

PROVIDER: S-EPMC11959358 | biostudies-literature | 2025 Apr

REPOSITORIES: biostudies-literature