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 (CMS). 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. Big Sioux Benefits handles the enrollment steps with you, so nothing is missed, at no cost to you.
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
- CMS — 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
- CMS — 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. We run these numbers for your own situation at Big Sioux Benefits, at no cost to you.
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. Book a conversation with Big Sioux Benefits and we will check this against your own plan, doctors and drugs, at no cost to you.
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.
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 or 1-800-MEDICARE for all of your options.