Good News for Seniors Using Insulin

Are you one of the 25% of seniors in the United States who have diabetes[1]? For many who have Type 2 diabetes, oral medications can be enough to keep blood sugar at a healthy level. But for others, insulin is required to stay healthy. And for those who have Type 1 diabetes, regular insulin injections are required to stay alive. But the cost of insulin can be prohibitive.

In 1923, the creators of insulin received a patent for the drug and almost immediately sold it to the University of Toronto for $1 each. One of the creators, Sir Frederick G. Banting, famously said, “Insulin does not belong to me, it belongs to the world.” The men who discovered insulin believed that by selling their patent for a token amount, they were assured that insulin would be affordable for the millions who needed it to survive[2].

It didn’t work out that way.

By 1941, three companies that made insulin – including Eli Lilly – were accused of illegal anti-trust violations for overcharging for insulin. Though they pleaded no contest and were fined, the rise in costs had just gotten started[3]. The price of insulin has risen by over 600% over the last 20 years even while the cost of creating the drug has remained extremely low[4].

The costs are especially surprising in the United States. Manufacturer prices for insulin in the US are 5 to 10 times higher than what is charged in other countries, according to a study by the RAND Corporation. Today, the average cost of insulin for Americans ranges between $300 and $1,000 a month. For some patients, that’s more spent on one element of their healthcare than what they spend on their mortgage or rent[5].

That out-of-control cost for what could be a life-saving drug might finally be curbed for those who are on Medicare.

The Government Curbs Insulin Costs for Seniors

The Inflation Reduction Act that was recently signed into law has many provisions meant to make life easier for the average American. One of those provisions is a cap on out-of-pocket expenses for insulin for the elderly. Starting on January 1, 2023, if you are on Medicare, you will pay no more than $35 per month for insulin. If you are on an insulin pump, those payments will kick in on July 1, 2023.

This is a very substantial savings for the 3.3 million Medicare beneficiaries who rely on insulin. Those on Medicare who did not receive low-income subsidies paid an average of $572 out of pocket for insulin in 2020[6]. With the costs of everything else rising due to inflation, seeing a substantial monthly savings in drug costs means that those who rely on insulin can use the extra money for things that can further improve their health, such as more fresh produce at the grocery store.

If you’re surprised by the savings on insulin, that might be because of the timing of it. The bill being signed into law came too late to include the changes in the Medicare plan finder. That means that if you looked through the plan finder to find the best bargain on insulin costs for the coming year, you didn’t see the option! However, Medicare beneficiaries will have the opportunity to switch plans throughout 2023 under a special enrollment period for “exceptional circumstances.[7]”

To make the change, talk to a professional at your State Health Insurance Assistance Program.

A Deeper Look at the New Savings

The bill does many other good things for the elderly. It allows Medicare to negotiate for cheaper prices for prescription drugs, which can pass savings on to you. It caps your out-of-pocket spending on prescription drugs at $2,000 a year – which can reduce medication costs quite substantially for some, especially those with chronic conditions who need certain medications to survive. And the bill makes sure that recommended vaccines for seniors, such as those for COVID and shingles, are always free.

Let’s dive deeper into what those savings really mean for you.

Though curbing the cost of insulin to a maximum of $420 out of pocket per year is a serious help for seniors, what about other drugs they might be taking? The cap on prescription drugs of $2,000 out of pocket per year can help those who are on more expensive medications breathe a sigh of relief. The Kaiser Family Foundation reports that 1.5 million seniors paid more than $2,000 in medication costs in 2019.

There could be more savings coming with the opportunity for Medicare to negotiate costs on specific drugs. Starting this year, the U.S. Department of Health and Human Services will identify the 100 most expensive drugs covered by Medicare and pick 10 of them for price negotiations. The lower prices negotiated in 2023 would take effect in 2026. Another 10 medications would be negotiated over the next two years, with those savings showing up in 2028.

What does that mean for you? It depends. If you are on one of the 20 drugs that are ultimately negotiated, you could see significant cost savings at the pharmacy in the coming years. Though some of these drugs might include high-dollar yet life-saving options, such as chemotherapy medications, some of them could include drugs that large populations of seniors take, such as those for high blood pressure, cholesterol, or diabetes.

Starting this year, all vaccines recommended for the elderly by the Advisory Committee on Immunization Practices are fully covered by Medicare with no out-of-pocket expense for you. Though some vaccines are recommended for everyone over the age of 65, such as COVID and pneumonia vaccines, others might be recommended only if you have certain underlying conditions. This page from the CDC can help you figure out which vaccines are recommended for you.

In addition, the Act prevents drug companies from raising their prices faster than inflation – that means there will be no price gouging for necessary and even life-saving medications at a time when so many Americans are struggling to make ends meet. To provide even more financial support for low-income seniors, those Medicare beneficiaries who earn between $18,347 and $20,385 per year will see low-income subsidies that help them pay for premiums. Premium increases on prescription drug plans is capped at 6% for through 2029[8].

Affordable health solutions become more important as we get older, especially if you are living with a chronic condition like diabetes. Staying safe and avoiding serious health scares is a vital part of aging in place. Using medical alert technology to get help fast in the event of an emergency can mean the difference between a good outcome and a bad one. Getting help right away means that you get faster treatment for that chest pain, breathing trouble, or injury suffered after a fall.

An emergency button alarm is right there at your fingertips in the form of a medical alert pendant, watch, or bracelet. When you press the button, a trained agent will come on the line, assess the situation, and send the proper assistance to your door. It’s an affordable option that provides peace of mind and might help you avoid the more serious consequences of not getting help in a timely manner.

Why Taking Your Insulin is So Important

For those who are not on Medicare, the costs of insulin can still be prohibitive, and that can lead to the temptation to ration the insulin. However, rationing can be a deadly practice. Just over one in every 10 elderly Americans ration their insulin to make it last longer, according to a study in the Annals of Internal Medicine. High blood sugars can lead to problems with heart disease, stroke, nerve damage, kidney disease, and so much more. The more severe consequences of rationing can include diabetic ketoacidosis, during which the blood sugar levels rise to deadly levels and the body begins to shut down[9].

It’s incredibly important to take your insulin and other diabetes medications exactly as directed by your physician. The American Diabetes Association can help you find assistance if the costs of insulin are too much to handle.

If you are on insulin or diabetic drugs, it’s important to be aware of the problems that can arise. From hypoglycemia, or low blood sugar, to the problems brought about by blood sugar that has risen out of control, you could suffer from a variety of symptoms that include dizziness, fatigue, fainting, unconsciousness, and more.

Every one of these symptoms is a very good reason to consider using a medical alert system with fall detection. Not only do you have help right at the touch of a button, you also have the peace of mind that if you can’t press that button after you suffer a fall, the fall sensors in the device will recognize what has happened and send an alert to summon help for you. That alone can mean a significant difference in your recovery.