Key takeaways
- Medicare Part D prescription drug plans and Medicare Advantage plans that include drug coverage typically offer the most comprehensive coverage for diabetes medications, including both oral and injectable options.
- Specific coverage and costs can vary between plans. However, most cover various antidiabetic drugs like sulfonylureas, biguanides, and thiazolidinediones, as well as different types of insulin and GLP-1 medications.
- To understand your specific coverage, it’s important to review your plan’s documentation, specifically its formulary and tier system. Or contact Medicare or your local State Health Insurance Assistance Program (SHIP) for personalized assistance.
Original Medicare (parts A and B) and Medicare Advantage (Part C) cover insulin administered via a pump and certain diabetes supplies.
Medicare Advantage plans with prescription drug benefits and stand-alone prescription drug (Part D) plans offer the most comprehensive coverage for diabetes medications.
Medicare Advantage and Part D plans cover a wide range of oral medications for diabetes. These often include:
- sulfonylureas, like glipizide (Glucotrol) and glyburide (Diabeta)
- biguanides, like metformin (Glumetza)
- thiazolidinediones, like nateglinide (Starlix) and repaglinide
- alpha-glucosidase inhibitors, like acarbose (Precose)
Medicare Advantage and Part D plans are sold by private insurance companies.
Each plan sets its own cost and coverage amounts. The premiums, deductibles, copayments, and coinsurance amounts you’ll pay depend on your chosen plan.
Prescription drug coverage depends on the plan’s formulary and tier system. The formulary, or list of covered medications, varies from plan to plan. Brand-name medications usually cost more than generics.
Part B covers durable insulin pumps worn outside the body and the insulin used in the pump.
After you pay your deductible — $257 in 2025 — Part B covers 80% of the Medicare-approved cost of the pump. Your coinsurance for a 1-month supply of insulin for a durable pump is $35.
Medicare Advantage and Part D plans cover injectable insulin and related supplies, such as syringes, needles, and swabs. Your coinsurance for a 1-month supply of injectable insulin is $35.
Medicare and GLP-1 medications for diabetes
Medicare Advantage and Part D plans may also cover GLP-1 receptor agonists like liraglutide (Victoza), semaglutide (Wegovy, Ozempic), and dulaglutide (Trulicity).
GLP-1 medications can be expensive and may come with higher copayments or coinsurance, depending on the drug’s tier in the plan’s formulary.
In 2025, Part D prescription drug plans have an out-of-pocket maximum of $2,000. This means that once you have spent this amount, you’ll pay nothing further for your prescription medications for the remainder of the calendar year. In 2026, this amount is set to increase to $2,100.
If you have questions about your coverage, you can call Medicare at 800-633-4227 (TTY: 877-486-2048).
You can also contact your local SHIP for additional assistance. To find a program near you, call the SHIP National Technical Assistance Center at 877-839-2675.
Most Medicare Advantage and Part D plans cover a range of diabetes medications, including oral medications, insulin, and other injectable drugs.
For insulin, you’ll typically pay $35 out of pocket for a 1-month supply. If a doctor or another healthcare professional prescribes a GLP-1 medication for diabetes, the out-of-pocket costs may be higher.
But starting in 2025, you’ll not pay more than $2,000 in out-of-pocket prescription drug costs.