What it means for you
Since 2023, Medicare caps what you pay for a month's supply of each covered insulin at $35. Before the cap, some Part D enrollees spent more than $2,300 a year on insulin.
Who benefits: People on Medicare who use insulin; 3.3 million Part D enrollees used insulin in 2020 according to KFF.
If you have Medicare and use insulin, you pay no more than $35 for a month’s supply of each insulin your plan covers. That’s true whether it comes through a Part D drug plan or, for people who use an insulin pump, through Part B. You don’t have to apply: the cap is built into every plan, and the deductible doesn’t apply to insulin.
Before the cap, insulin costs varied widely. In 2020, some Part D enrollees without low-income subsidies spent more than $2,300 for insulin over the year. Starting in 2021, a voluntary pilot under the Trump administration let drug plans that opted in charge $35 a month; the new law made the cap apply to every plan.
Sen. Raphael Warnock and Rep. Angie Craig led the push in 2022, and Craig’s bill passed the House 232–193 that March. The cap became part of the Inflation Reduction Act, which Senate Majority Leader Chuck Schumer and Sen. Joe Manchin negotiated and Democrats passed without Republican votes. A cap for private insurance fell short in the Senate. The Senate split 50–50 and Vice President Kamala Harris broke the tie. President Joe Biden signed it on August 16, 2022. The Part D cap started January 1, 2023, and the Part B cap followed that July.
Health careLower costsSeniors
Sources
- Insulin coverageMedicare.gov
- H.R. 5376, Inflation Reduction Act of 2022Congress.gov
- Insulin Out-of-Pocket Costs in Medicare Part DKFF
- Joint Statement From Leader Schumer and Senator Manchin Announcing AgreementSenate Democratic Caucus, July 27, 2022
- Senator Reverend Warnock celebrates his $35 Medicare insulin cost cap taking effectOffice of Sen. Raphael Warnock, January 3, 2023
- House passes Representative Angie Craig's bill to cap insulin copays at $35 a monthOffice of Rep. Angie Craig
- Roll Call 102, H.R. 6833Office of the Clerk, U.S. House of Representatives, March 31, 2022
- CMS launches groundbreaking model to lower out-of-pocket expenses for insulinCenters for Medicare & Medicaid Services, March 11, 2020
How we checked this
Drafted by Claude Opus 5.5 (Anthropic) on November 11, 2026. Checked against its sources by GPT-5.6-sol (OpenAI) on November 11, 2026, which corrected it. Confirmed the $35 cap remains in effect, checked the law, benefit dates, credits, impact figures, and both official roll calls. Corrected the Senate vote total and updated the status check date.
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