Does Medicare Cover Levemir?
- Many people with diabetes find Levemir helpful for controlling their blood sugar, but it's a costly drug. Find out whether your Medicare plan covers Levemir.
Levemir is significantly more expensive than many other drugs used to treat diabetes. Therefore, checking whether your Medicare plan covers your medication is sensible. Below, you can learn whether Medicare Part D and Medicare Advantage plans cover Levemir.
What Is Levemir?
Levemir is an expensive injectable medication containing insulin detemir. Your doctor may suggest that you take Levemir to reduce your blood sugar levels if you have type 1 or type 2 diabetes. The effects of Levemir are long-lasting, stabilizing the blood sugar levels for longer and reducing the risk of hypoglycemia.
There's no cheaper generic version of Levemir, and it's only available with a doctor's prescription. The correct Levemir dosage varies from person to person. The most common dosage used to treat type 1 diabetes is 33% of the daily insulin requirement, while most people with type 2 diabetes take 10 units per day.
Levemir Side Effects
Several side effects are associated with Levemir. These include:
- Dangerously low blood sugar
- Colds
- Flu
- Allergic reactions
- Potassium deficiency
- Headache
- Sore throat
- Stomach pain
- Edema
- Weight gain
Does Medicare Cover Levemir?
Many Medicare Part D and Medicare Advantage plans cover insulin. Medicare Part B may also cover 80% of the approved amount for your treatment if you use an insulin pump.
However, Medicare plans with prescription drug coverage rarely cover Levemir specifically. Therefore, you're highly unlikely to be eligible for coverage, even if you have a Medicare Part D plan or a Medicare Advantage with prescription drug benefits.
However, there may be exceptions, and the list of covered drugs (formulary) varies from insurer to insurer. Therefore, it's worth checking your insurer's formulary in case your plan is one of the few offering Levemir coverage.
How Much Does Levemir Cost With Medicare?
Most Medicare enrollees must pay for Levemir themselves. Usually, Levemir costs between $525 and $615 for five FlexTouch pens containing 3 milliliters of medication. Prices at your local pharmacy may vary, and you may be able to get your prescription for less by subscribing to a discount voucher service.
If your plan covers Levemir, your insurer pays for your medication after you meet your deductible. As the maximum Medicare Part D deductible is $545 in 2024 (rising from $505 in 2023), you may satisfy your deductible by paying for a single Levemir prescription. However, co-pays for Levemir are typically high, costing around $532 on average.
Medicare Coverage Restrictions for Levemir
As Medicare coverage for Levemir is exceptionally rare, it's unclear whether eligible enrollees should expect coverage restrictions.
