Skip to main content

Independent; not a government site. Official answers: Medicare.gov, 1-800-MEDICARE.

Is Humalog Mix (insulin lispro / insulin lispro protamine, human) covered by Medicare Part D?

1,846 of 5,052 Medicare Part D plan offerings (36.5%) list Humalog Mix on their 2026 formulary, most often on tier 3; 0.6% of the formularies that cover it require prior authorization. Part D spending on it was $73 million in 2024 for at least 39,245 people: what plans and patients paid at the pharmacy, before manufacturer rebates (CMS Part D Spending by Drug).

Plans that cover it
36.5%
1,846 of 5,052 offerings; the median drug: 76%
Usual tier
Tier 3
from tier 1 to tier 6
Prior authorization
0.6%
of formularies that cover it; the median drug: 1%
Quantity limits
30%
of formularies that cover it; the median drug: 30%

Source: CMS Part D formulary file, 2026 second quarter: the formularies in use in 2026. A plan's 2027 formulary can differ; check your own plan's coverage in Medicare Plan Finder.

What does it cost under Part D in 2027?

Insulin costs at most $35 a month
A one-month supply of each Part D-covered insulin costs no more than $35, and the drug deductible does not apply to insulin.
Your yearly cap in 2027
Out-of-pocket spending on covered Part D drugs stops at $2,400 in 2027 ($2,100 in 2026); after that, you pay nothing for covered drugs for the rest of the year.
The deductible
A plan's drug deductible is at most $700 in 2027 ($615 in 2026); many plans charge less or none.

Source: CMS, Announcement of calendar year 2027 Part D parameters; Medicare.gov, “How much does Medicare drug coverage cost?”; Medicare.gov, “Insulin” (read Oct. 7, 2026).

How much does Medicare spend on it?

Part D spending by year

2020$401 million
2021$362 million
2022$323 million
2023$300 million
2024 (latest)$73 million

39,245 people filled it under Part D in 2024, in 231,378 claims. The amounts are what plans and patients paid at the pharmacy, before manufacturer rebates.

Source: CMS Medicare Part D Spending by Drug, 2020 to 2024 (published June 2026). Row used: Humalog Mix 50-50 (Insulin Lispro Protamin/Lispro), Humalog Mix 50-50 Kwikpen (Insulin Lispro Protamin/Lispro), Humalog Mix 75-25 (Insulin Lispro Protamin/Lispro), Humalog Mix 75-25 Kwikpen (Insulin Lispro Protamin/Lispro).

Which forms and strengths are counted?

  • 3 ml insulin lispro 25 units/ml / insulin lispro protamine, human 75 units/ml pen injector
  • 3 ml insulin lispro 50 units/ml / insulin lispro protamine, human 50 units/ml pen injector
  • insulin lispro 25 units/ml / insulin lispro protamine, human 75 units/ml injectable suspension

Which other versions are listed?

The same ingredients under other names, each with its own coverage and spending.

What else should you check?

Data, not medical advice. Coverage is the share of plan formularies listing the drug; your plan's formulary, tier and pharmacy decide what you pay.