CMS Changes Medicare Prescription Coverage for Insulin and Vaccines


October 19, 2022

On Jan. 1, 2023, cost sharing for insulin products will be capped at $35, which may be less than plans’ stated cost share.
Also, effective Jan. 1, 2023, adult vaccines recommended by the Centers for Medicare & Medicaid Services will be covered at $0 cost share.
Why it matters:
The insulin cost share cap and $0 cost share adult vaccines will be provided regardless of formulary tier or benefit phase. Log in to get details.

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Last Updated: Dec. 06, 2023