How much is insulin with Medicare in Arizona in 2026?
With Medicare Part D or a Medicare Advantage drug plan, covered insulin costs no more than $35 for a month's supply in 2026, and the Part D deductible does not apply to it.
These are national Medicare figures from CMS, not Arizona-only prices. insulin is used to control blood sugar in people with diabetes. What you pay at a pharmacy in Chandler or anywhere in Arizona depends on your plan's deductible, the tier insulin sits on, and whether you have reached the yearly cap.
| Measure | Figure |
|---|---|
| Most you pay for a month of covered insulin, 2026 | $35 |
| Medicare negotiated price, 30-day supply (2026) | $119 |
| List price CMS reported before negotiation, 30-day supply | $495 |
| Average gross Part D cost per claim, 2025 (national) | $260.58 |
| Average gross Part D cost per claim, Q1 2026 (national, preliminary) | $239.55 |
| People with Part D who used it in 2025 (national) | 90,194 |
| Part D out-of-pocket cap, 2026 / 2027 | $2,100 / $2,400 |
How Part D pricing works for this drug
Your plan pays the pharmacy a negotiated price, and your share comes in three steps, in this order:
Step 1, the deductible: it does not apply to covered insulin, so the $35 monthly limit starts with your first fill.
Step 2, your tier: after the deductible you pay the copay (a flat dollar amount) or coinsurance (a percentage of the price) set by the tier insulin sits on in your plan.
Step 3, the yearly cap: once your out-of-pocket drug spending reaches $2,100 in 2026 ($2,400 in 2027), you pay $0 for covered Part D drugs for the rest of the year.
In 2025, 90,194 people with Part D filled insulin, at an average gross cost of $260.58 per claim. A claim can be a 30-day or 90-day fill, so treat that as a guide to scale, not a monthly bill.
What changes the answer
The $35 cap applies to each covered insulin product on your plan's formulary. NovoLog and Fiasp also have a Medicare negotiated price of $119 for a 30-day supply in 2026 (list $495); CMS lists them as removed from the program effective January 1, 2027. The average gross Part D cost per NovoLog claim was $260.58 in 2025 and $239.55 in the first quarter of 2026, which shows how much the cap protects you. Insulin used through a traditional pump is covered under Part B, where the $35 cap also applies.
Formularies are set plan by plan. The 2027 drug lists are published by each plan for Annual Enrollment, and CMS has not yet released its 2027 formulary files, so check your own plan's 2027 list and tier. People with limited income can apply for Extra Help through Social Security, which lowers drug copays.
What to do next
Bring your prescription list to a plan review. During Annual Enrollment, October 15 to December 7, 2026, we compare how insulin is covered on the 2027 plans we offer in Maricopa and Pinal counties, including tier, deductible and pharmacy, and show you the yearly total rather than one copay.
Related questions
How much is insulin with Medicare in Arizona in 2026?
With Medicare Part D or a Medicare Advantage drug plan, covered insulin costs no more than $35 for a month's supply in 2026, and the Part D deductible does not apply to it.
Is insulin covered by Medicare?
insulin is covered under Medicare Part D drug plans and Medicare Advantage plans with drug coverage when it is on the plan's formulary. Coverage, tier and any prior authorization vary by plan.
What is the most I can pay for Part D drugs in a year?
$2,100 in 2026 and $2,400 in 2027 for covered Part D drugs. After that you pay $0 for covered drugs for the rest of the year.
Does the $35 cap cover insulin used in a pump?
Yes. Insulin used through a traditional pump is covered under Part B rather than Part D, and the $35 monthly cap applies there too. Insulin you inject with pens or syringes is covered under your Part D or Medicare Advantage drug plan, as long as it is on the plan's drug list.
Can Extra Help lower what I pay for insulin?
Yes, if you qualify. Extra Help is a federal program, applied for through Social Security, that lowers Part D premiums, deductibles and copays for people with limited income and resources. In Arizona, people with full AHCCCS coverage or a Medicare Savings Program usually get it automatically. We can help you check.
Can I spread my insulin costs over the year?
Yes. The Medicare Prescription Payment Plan lets you pay your out-of-pocket Part D drug costs in monthly amounts across the calendar year instead of all at once at the pharmacy. It does not lower the total you pay, but it can help when a deductible or high copay lands early in the year. Ask your plan to sign you up.
How do I check whether my 2027 plan covers insulin?
Look up insulin on each plan's 2027 drug list, called the formulary, and note the tier and any prior authorization or quantity limits. During Annual Enrollment, October 15 to December 7, 2026, we can compare it across the 2027 plans we offer in Maricopa and Pinal counties and show you the yearly total.
Does what I pay for insulin count toward the yearly drug cap?
Yes. What you pay for covered insulin counts toward the Part D out-of-pocket cap, $2,100 in 2026 and $2,400 in 2027. Once your total reaches the cap, you pay $0 for covered Part D drugs, insulin included, for the rest of the year.
Does the $35 insulin cap apply before the deductible?
Yes. Covered insulin is capped at $35 for a month's supply and the Part D deductible does not apply to it.
Sources
- CMS Medicare Quarterly Part D Spending by Drug Centers for Medicare & Medicaid Services
- CMS fact sheet: negotiated prices for initial price applicability year 2026 Centers for Medicare & Medicaid Services
- CMS: Selected drugs and negotiated prices Centers for Medicare & Medicaid Services
- CMS Medicare Advantage and Part D Landscape, Contract Year 2027 Centers for Medicare & Medicaid Services
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