How much is insulin with Medicare in Arizona in 2027?
With Medicare Part D or a Medicare Advantage drug plan, covered insulin costs no more than $35 for a month's supply in 2027, and the Part D deductible does not apply to it.
Prices are national Medicare figures from CMS, and the deductible range is from the 2027 plan files for Maricopa County. insulin is used to control blood sugar in people with diabetes. What you pay at a pharmacy in Chandler, AZ or anywhere in Arizona depends on your 2027 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, 2027 | $35 |
| Medicare negotiated price, 30-day supply, 2027 | None: removed from the program January 1, 2027 |
| Negotiated price, 30-day supply, 2026 (before) | $119 |
| List price CMS reported before negotiation, 30-day supply | $495 |
| Part D deductible, 2027 standard maximum | $700 ($615 in 2026) |
| Part D deductibles on Maricopa County 2027 drug plans (85 plans) | $0 to $700 |
| Part D out-of-pocket cap, 2027 | $2,400 ($2,100 in 2026) |
| 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 |
How Part D pricing works for this drug in 2027
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 of 2027.
Step 2, your tier: after the deductible you pay the copay or coinsurance set by the tier insulin sits on. Under the standard design CMS publishes, that is 25% of the drug's cost.
Step 3, the yearly cap: once your out-of-pocket spending on covered drugs reaches $2,400 in 2027 (up from $2,100 in 2026), you pay $0 for covered Part D drugs for the rest of the year.
Worked year: at the $35 monthly limit, a full year of one covered insulin costs you no more than $420, and that spending counts toward the yearly cap.
What changes the answer
The $35 cap applies to each covered insulin product on your plan's 2027 formulary. NovoLog and Fiasp had a Medicare negotiated price of $119 for a 30-day supply in 2026 (list $495); CMS removed them from the program effective January 1, 2027, which does not change the $35 cap. 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.
For scale, 90,194 people with Part D filled insulin in 2025, at an average gross cost of $260.58 per claim (national CMS data; a claim can be a 30-day or 90-day fill). Formularies are set plan by plan, so the tier and any prior authorization on your own 2027 plan decide your copay. 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 2027?
With Medicare Part D or a Medicare Advantage drug plan, covered insulin costs no more than $35 for a month's supply in 2027, and the Part D deductible does not apply to it.
Is insulin covered by Medicare in 2027?
insulin is covered under Medicare Part D drug plans and Medicare Advantage plans with drug coverage when it is on the plan's 2027 formulary. Coverage, tier and any prior authorization vary by plan.
What is the most I can pay for Part D drugs in 2027?
$2,400 for covered Part D drugs, up from $2,100 in 2026. 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 2027 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 2027?
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 helps when the deductible lands in January. Ask your plan to sign you up.
How do I check whether my 2027 plan covers insulin?
We do it with you. During Annual Enrollment, October 15 to December 7, 2026, we look up insulin on the 2027 drug list of each plan we offer in Maricopa and Pinal counties, note the tier and any prior authorization or quantity limits, and show you the yearly total.
Does what I pay for insulin count toward the 2027 drug cap?
Yes. What you pay for covered insulin counts toward the $2,400 Part D out-of-pocket cap for 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 in 2027?
Yes. Covered insulin is capped at $35 for a month's supply and the Part D deductible does not apply to it.
Sources
- CMS Selected Drug List and Maximum Fair Price data file (September 21, 2026 release) Centers for Medicare & Medicaid Services
- CMS Announcement of Calendar Year 2027 Medicare Advantage Capitation Rates and Part C and Part D Payment Policies Centers for Medicare & Medicaid Services
- CMS Medicare Advantage and Part D Landscape, Contract Year 2027 Centers for Medicare & Medicaid Services
- 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
Please note: We do not offer every plan available in your area. Currently we represent 34 organizations which offer 64 products in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.Rise Up Benefits Group is not connected with or endorsed by the United States government or the federal Medicare program. Medicare has neither endorsed nor reviewed this information.
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