Bill Redmond, interim SHINE regional manager
508-375-6762 | wiliam.redmond@barnstablecounty.org
Barnstable County Dept. of Human Services | 3195 Main St. | P.O. Box 427 | Barnstable, MA 02630

Inflation Reduction Act and insulin

This law, which was passed in August, will cap all insulins in 2023 at $35 a month that are covered by your Part D or Medicare Advantage plan. The cap applies over all phases, including in the gap. It also applies to the plan’s preferred pharmacies and standard pharmacies. Some plans already slated copays below $35 a month.

If you use a traditional insulin pump, it is durable medical equipment that falls under Medicare Part B. The insulin to supply the pump also falls under Part B. Medicare Part B will not be updated for insulin savings until July 1, and neither will supplement plans/Medigaps.

Drug plans had to submit their cost data and formularies, which determine whether a medication is covered and at what tier, to Medicare in April. Drug plans can only change their formularies during the year with Medicare approval. Because the law was passed after the plans’ submission deadline, Medicare may allow Special Enrollment Periods if coverage of the insulins drops due to the change in law and/or the plan finder reflects old information.

The law will be good in the long run; but, there may be teething pain in the short run. If the cost of filling your insulin prescription proves different than expected in 2023 and is more than $35 a month, you may want to meet with a SHINE counselor during 2023.

Martha’s Vineyard Counselor Recruitment

Have you retired to Martha’s Vineyard, but still want important and rewarding work that serves your new community? Do you like to solve puzzles? If yes, you might consider becoming a SHINE Counselor. SHINE stands for Serving Health Insurance Needs of Everyone. We help people on Medicare, or who are becoming Medicare-eligible, figure out the health and prescription plan options to go with Medicare. This is true for those turning 65 and for those under 65 who become eligible due to a disability.

To learn more about becoming a SHINE counselor, please contact the regional SHINE office at 508-375-6762, ext. 3.