Part D Insulin Price Changes Explained for 2021

There has been some confusion surrounding the $35 copay on insulin. Part D insulin prices are changing in 2021, but who is offering it? How do you know which plan has it? Will you automatically be eligible for that plan? We’ve even heard of people assuming that all insulin is $35 for AEP 2021. Sadly, that is not the case. Carriers had to apply to get this plan so they aren’t able to offer $35 insulin all of their Part D plans, or plans in general.

A lot of agents seem to think if a national carrier offers this on a Part D, then all of their plans offer it — that is not the case. It varies by plan and by carrier. Don’t make assumptions here! Getting this discount on Insulin could provide major savings for your clients. Under original Medicare, the clients are paying 100% out of pocket for syringes, needles, alcohol swabs, gauze, and insulin. Part D plans provide some relief here.

The only way to be 100% sure is to check out the $35 insulin filter on

Insulin Pumps

Note, that medical insulin pumps are categorized a little differently and coverage can be provided under Part B or Part C plans depending on the specifics. These vary based on what area of the country you are in.

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Sylvia Gordon and her sister, Rebecca, run Gordon Marketing, one of the nation’s largest Medicare FMO/NMA offices. They have a team of over 100 that train and support independent insurance agents in all 50 states. You can find Sylvia’s weekly posts on LinkedIn and the sisters' Youtube channel posts 2 training videos each week. Contact Sylvia at or 800-388-8342.


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