Is insulin lispro / insulin lispro protamine, human covered by Medicare Part D?
1,432 of 5,052 Medicare Part D plan offerings (28.3%) list insulin lispro / insulin lispro protamine, human on their 2026 formulary, most often on tier 3; 0% of the formularies that cover it require prior authorization.
- Plans that cover it
- 28.3%
- 1,432 of 5,052 offerings; the median drug: 76%
- Usual tier
- Tier 3
- from tier 1 to tier 7
- Prior authorization
- 0%
- of formularies that cover it; the median drug: 1%
- Quantity limits
- 11.7%
- of formularies that cover it; the median drug: 30%
5.4% of the formularies that cover it require step therapy (trying another drug first).
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).
Which forms and strengths are counted?
- 3 ml insulin lispro 25 units/ml / insulin lispro protamine, human 75 units/ml pen injector
Which other versions are listed?
The same ingredients under other names, each with its own coverage and spending.
- Humalog Mix (insulin lispro / insulin lispro protamine, human)36.5% of plan offerings
What else should you check?
- Stand-alone drug plans for 2027Premiums and deductibles
- Drugs Medicare spends the most onThe 2024 spending list
- 2027 costs and limitsDeductibles and out-of-pocket limits
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.