What Your Prescriptions Cost
How much does NovoLog cost with Medicare in 2026?
Last reviewed: · Big Sioux Benefits Data Desk
You will not pay more than $35 for a one-month supply of NovoLog or Fiasp, because the federal insulin cap overrides ordinary Part D cost sharing (Medicare.gov). Separately, this insulin family received a Medicare-negotiated price of $119 for a 30-day supply as of January 1, 2026, down from a $495 list price, a 76% reduction (CMS). Two different rules, both working in your favor, and the $35 cap is the one you feel at the counter.
The qualifier: the $35 applies per covered insulin product per month's supply, and the Part D deductible does not apply to it. If you get a three-month supply, your cost cannot exceed $35 for each month's supply, so no more than $105. The cap applies at any in-network pharmacy, preferred or not, and it applies to everyone who takes insulin, including people who get Extra Help.
The two rules side by side
| Insulin cap | Negotiated price | |
|---|---|---|
| What it sets | What you pay: no more than $35 per month's supply | What the drug costs: $119 per 30-day supply |
| Deductible applies? | No | Ordinarily yes, but the insulin cap overrides it here |
| Varies by pharmacy? | No, same at any in-network pharmacy | No, it is a national price |
| Applies with Extra Help? | Yes, and Extra Help recipients often pay less | Yes |
One detail almost nobody knows, and it works to your advantage: the amount you would have paid above the $35 cap still counts toward your annual out-of-pocket total. So insulin moves you toward the $2,100 cap faster than your $35 receipts suggest, which matters if you take other expensive drugs as well. The full insulin picture, including Part B pump coverage, is in how much insulin costs with Medicare.
Sources
- Medicare.gov — Costs for Medicare drug coverage — accessed 2026-08-21
- CMS — Medicare Drug Price Negotiation Program: Negotiated Prices for Initial Price Applicability Year 2026 — prices effective January 1, 2026; accessed 2026-08-21
- Medicare.gov — Help with drug costs (Extra Help) — 2026 limits and amounts; accessed 2026-08-21
Related questions
Does the $35 insulin cap apply before I meet my deductible?
Yes. The Part D deductible does not apply to covered insulin, so you pay no more than $35 for a month's supply from the first fill of the year. Your $35 payment does count toward meeting your deductible and toward your out-of-pocket total.
Do I pay $35 at any pharmacy?
At any in-network pharmacy covered by your drug plan, yes, and the amount is the same whether that pharmacy is preferred or standard. This is one of the few places in Part D where preferred pharmacy status does not change your price.
Drug costs turn on your specific prescriptions, so the arithmetic is worth doing once, properly: book a free, no-pressure conversation, see your county's South Dakota plan lineup, or browse all answers. SHIINE, the state's free counseling program, is at 1-800-536-8197 and sells nothing.
Big Sioux Benefits is a licensed insurance agency, not affiliated with or endorsed by the U.S. government or the federal Medicare program. We do not offer every plan available in your area. Contact Medicare.gov, 1-800-MEDICARE, or SHIINE (South Dakota's SHIP) for all of your options.