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MEDICARE ANSWERS

What insulin costs count toward my True Out-of-Pocket costs?

What insulin costs count toward my true out-of-pocket (TrOOP) costs? What about my Part D deductible?

Your $35 (or less) copayment for a month's supply of each insulin product counts toward your TrOOP. Before you meet your Part D deductible, your $35 (or less) copayment will be applied to your deductible.

In 2023, the amount you would have paid (above the $35 cap) for a covered insulin product will also count toward your:

  • Deductible
  • Total true out of pocket (TrOOP) costs.
  • Progression through the Part D coverage phases.

MedHelpCenter.us recommends that you call the Senior Health Insurance Agency at 813-592-8568 for further help and explanation.

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