Most people with insurance pay between $35 and $100 per month for insulin, depending on the type of insurance, the state they live in, and which insulin product they use. That range has dropped significantly since 2023, when all three major insulin manufacturers cut list prices and federal law capped costs for Medicare enrollees at $35 per month.
Medicare: $35 Per Month, No Deductible
If you have Medicare, insulin costs are straightforward. The Inflation Reduction Act caps your out-of-pocket cost at $35 for a one-month supply of each covered insulin product, whether it’s covered under Part B (for use with an insulin pump) or Part D (the prescription drug benefit). You don’t have to meet your deductible first, and the cap applies even if you receive Extra Help, the federal program that lowers drug costs for people with limited income.
This means if you use two different insulin products, such as a long-acting and a rapid-acting insulin, you’d pay up to $35 for each, totaling $70 per month at most.
Private Insurance: $35 to $99 Per Fill
For people with employer-sponsored or marketplace insurance, costs vary more widely. Before the recent price cuts, privately insured patients paid an average of $63 per 30-day fill, though that figure masked huge variation. Half of all fills cost $9 or less out of pocket, while others ran well into the hundreds.
Starting January 1, 2024, all three major insulin manufacturers, Eli Lilly, Novo Nordisk, and Sanofi, slashed their list prices by up to 78%. Eli Lilly and Sanofi also committed to capping out-of-pocket costs at $35 per month for people with private insurance who use participating pharmacies. Novo Nordisk reduced list prices on its most popular pens and vials by up to 75%.
What you actually pay depends heavily on where your insulin sits on your plan’s formulary, the list of drugs your insurer covers. Formularies organize drugs into tiers. “Preferred” brand-name drugs sit on a lower tier with a moderate copay, while “non-preferred” drugs land on a higher tier with steeper costs. If your plan places your insulin on a preferred tier, you’ll generally pay a flat copay of $30 to $50. On a non-preferred tier, you could face a higher copay or a percentage of the drug’s cost (coinsurance), which can climb past $100 before any savings programs kick in.
The simplest way to lower your cost is to ask your doctor whether a preferred insulin on your plan’s formulary would work for you. Switching from a non-preferred to a preferred product can cut your copay in half or more.
High-Deductible Plans and HSAs
High-deductible health plans used to be a particular pain point for insulin users, because you’d have to pay the full cost of prescriptions until you hit your deductible, sometimes thousands of dollars into the year. That changed in 2023. The Inflation Reduction Act added a specific exemption allowing high-deductible plans to cover insulin before the deductible is met without losing their qualification for health savings accounts (HSAs).
The IRS clarified that this applies to all insulin products regardless of the specific diagnosis, whether you’re using insulin to manage type 1 diabetes, type 2 diabetes, or prevent complications. Devices used to administer insulin, like pen needles and pump supplies, are also included in this exemption. So if you’re on a high-deductible plan, check with your insurer: your insulin copay may now be comparable to what people on traditional plans pay, even in January before you’ve spent anything toward your deductible.
State Laws That Cap Your Copay
At least 26 states and the District of Columbia have passed laws capping monthly insulin copays for state-regulated insurance plans. These caps range from $0 to $100 per 30-day supply, and they apply to plans your state regulates, which typically means individual and small-group market plans. Large employer plans that are self-funded (where the employer pays claims directly rather than buying insurance) are regulated by federal law instead and aren’t covered by state caps.
The lowest caps are in New York ($0), Connecticut, Massachusetts, Minnesota, New Mexico, North Dakota, and Texas (all $25). Several states set their cap at $30, including the District of Columbia, Kentucky, Maryland, New Hampshire, Oklahoma, and Utah. States like California, Illinois, Maine, Montana, Nebraska, Nevada, New Jersey, and Washington cap at $35. A handful of states, including Alabama, Colorado, Delaware, and Vermont, set caps at $100.
If you live in one of these states and your insurance is state-regulated, the cap applies automatically. You don’t need to enroll in anything. But it’s worth confirming with your insurer that your specific plan falls under state regulation.
Manufacturer Savings Programs
Even with insurance, manufacturer copay cards can lower your cost further. Eli Lilly offers a savings program that brings the cost of its insulin products down to $35 per fill, with up to $7,500 in annual savings. Novo Nordisk and Sanofi run similar programs, though their savings cards typically bring costs to $99 per fill with savings of $100 to $150 per monthly supply.
These savings programs are designed for people with commercial insurance and won’t stack with Medicare or Medicaid. They usually require registering on the manufacturer’s website or activating a card at the pharmacy. For uninsured patients, all three manufacturers offer patient assistance programs that provide insulin at no cost, and Eli Lilly’s Insulin Value Program and Novo Nordisk’s Insulins Valyou Savings Program both offer $35-per-month options for people without coverage.
What Drives Your Actual Cost
Your final monthly cost comes down to a few key variables working together. The type of insurance you have sets the baseline: Medicare is capped at $35, Medicaid typically has minimal or no copays, and private insurance varies. Your plan’s formulary determines whether your specific insulin is preferred or non-preferred. Your state’s laws may impose a cap that overrides your plan’s standard cost-sharing. And manufacturer savings programs can reduce whatever remains.
If you’re paying more than $35 to $50 per month for insulin with insurance, it’s worth investigating each of these layers. Start by checking whether your state has a copay cap, then look at your plan’s formulary for a preferred alternative, and finally check if the manufacturer offers a savings card for your product. Most people can get their monthly cost into the $25 to $50 range by working through those steps.