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Insulin lispro 75/25 Medicare coverage

Generic Humalog 75/25

Used for Diabetes Type 1, Diabetes Type 2

Humalog 75/25 is an insulin mix that contains 75% insulin lispro protamine (an intermediate-acting insulin) and 25% insulin lispro (a rapid-acting insulin). It's used to control blood sugar levels in adults with Type 1 diabetes or Type 2 diabetes. Humalog 75/25 is injected under the skin, typically twice daily 15 minutes before a meal. Some side effects of this medication include low blood sugar (hypoglycemia) and reactions at the injection site. Humalog 75/25 comes as a vial and pen (KwikPen), and is available as a generic medication.

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$319.81(Save 74.56%)
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$81.36
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Common Medicare glossary terms
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Annual Notice of Change (ANOC):

The Medicare Annual Notice of Change (ANOC) is a letter for people enrolled in Medicare Advantage plans and anyone with Medicare Part D prescription coverage. People with Medicare Advantage or original Medicare (Part A and/or Part B) can have Part D plans. The ANOC informs enrollees about any changes to their benefits for the coming coverage year. By law, Medicare Advantage and Part D plans must send the ANOC to enrollees by September 30 — which is before the annual Medicare open enrollment period of October 15 to December 7. Even if you have the same plan, your benefits could change year to year.

Premium:

A premium is the cost of having a health insurance plan and is usually paid monthly. Medicare enrollees may pay several premiums. Most people don’t pay anything for Part A hospital insurance, but some people do depending on how long they worked and paid taxes. For outpatient and preventive coverage, the Part B standard premium is $185 a month in 2025, but people with higher incomes pay more. Your premium for Medicare Advantage plans will vary, but even so-called “zero premium” plans require you to pay your Part B premium. Part D premiums range in price, but the average is about $47 a month in 2025. If you have original Medicare and a Medigap supplement plan, you have an additional premium for that coverage.

Deductible:

A deductible is the amount you pay out of pocket before your Medicare plan begins cost-sharing. In 2025, the Part A deductible is $1,676 per benefit period. The Part B deductible is $257 for the year, but you can access certain preventive care — including some vaccines — without meeting your deductible. Medicare Advantage deductibles vary and your Part D deductible can’t exceed $590 in 2025.

Out-of-pocket limit:

Original Medicare has no annual out-of-pocket maximum. Medicare Advantage plans have out-of-pocket limits. In 2025, they are $9,350 for in-network covered services and $14,000 for in-network and out-of-network covered services combined.

Medicare Prescription Payment Plan:

Starting January 1, 2025, anyone with Part D coverage had the option to use the Medicare Prescription Payment Plan for their out-of-pocket medication costs instead of paying upfront at the pharmacy. This plan doesn’t provide savings, but allows you to spread prescription costs — including your deductible — over the year. Making payments can be particularly helpful for people who may skip or delay picking up prescriptions because of high costs early in the year. Also in 2025, the Part D out-of-pocket limit dropped to $2,000.

Initial coverage phase:

After a Medicare enrollee meets the Part D deductible (if the plan has one), the health insurance begins cost sharing. The initial coverage phase means you pay coinsurance or a copay for covered prescriptions.

Catastrophic phase:

When you reach the $2,000 out-of-pocket maximum, your Part D plan pays for 100% of covered medications for the rest of the year.

Medication ready
How to save on drugs with Medicare

Medicare Part D is the part of Medicare that helps cover prescription medications, including both brand name and generic. It also includes coverage for certain vaccines that aren’t covered by Part B, as well as some medical supplies.

Even with Medicare Part D coverage, you may still have out-of-pocket costs such as premiums, deductibles, copayments, and coinsurance. As of 2025, Medicare Part D plans include a $2,000 annual out-of-pocket cap. Once you reach this limit, your plan covers the full cost of your covered medications for the rest of the year.

Still, there are several ways to reduce your prescription medication cost. From GoodRx coupons to patient assistance programs, here are ways you can save money on the medications you need.

1. See if you qualify for Medicare’s Extra Help program

The Medicare Extra Help/Low-Income Subsidy program is a federally funded program for people covered under a Medicare Part D plan. It helps reduce enrollees’ out-of-pocket costs by limiting their deductibles and copays. To qualify, your income and assets fall below a certain limit.

If you’re eligible, you may receive:

  • No monthly premiums for Medicare Part D

  • No Medicare Part D deductible

  • Low copays for prescription medications

2. Use GoodRx coupons

You can’t combine GoodRx coupons with Medicare, but you can choose to use a coupon instead of your insurance if it results in a lower price.

Here’s how to download a GoodRx coupon:

  1. Go to the GoodRx website, or download the GoodRx app on your phone.

  2. Search for your prescription medication.

  3. Enter your prescribed dose and quantity, then set your location.

  4. Compare prices across different pharmacies in your area.

  5. Click “Find the lowest prices” or press “Enter.”

  6. You can have the coupon sent by text or email, or print it out.

  7. To apply the discount, show the coupon at the pharmacy when you fill your prescription. Ideally, this is done at drop-off before the prescription is filled.

3. Consider the Medicare Prescription Payment Plan

The Medicare Prescription Payment Plan is a new program that can help make paying for medications more manageable. It’s open to anyone with a standalone Part D plan or those with Medicare Advantage plans that offer prescription medication coverage.

There is no cost to participate in the Medicare Prescription Payment Plan and participation is voluntary. Instead of paying for the total cost of your medications up front at the pharmacy, the payment plan allows you to spread the cost into smaller payments during the year. If you join, you will continue to pay your premium every month as well as an additional monthly amount on your payment plan. It’s a good idea to review how the Medicare Prescription Payment Plan works to determine if it’s right for you.

4. Compare Part D plans during open enrollment

Medicare open enrollment, which takes place every year from October 15 to December 7, is your chance to switch plans if another option offers better prescription medication coverage or lower costs. Plan costs and coverage details can change each year, so it’s important to review your options.

Here are some steps to help you compare plans:

  1. Make a list of all your medications and what dosages you take.

  2. Enter the names of your prescription medications to see which plans offer the best coverage.

  3. Look at premiums, deductibles, and medication costs for each plan. Plans usually change their formularies, premiums, and copays annually.

  4. Check if your preferred pharmacy is in each plan's network.

5. Get a 90-day supply

Opting for a 90-day supply instead of a monthly refill of your medication might help reduce your long-term out-of-pocket costs. Many insurance plans offer lower copays or bulk pricing for 3-month prescriptions.

If your medication is covered under your plan, see if your insurer’s mail-order or specialty pharmacy provides savings on a 90-day supply. If they do, ask your prescriber to write a prescription for a 90-day quantity to take advantage of these potential savings.

6. Ask about the generic version of your medication

Some medications have a generic version, and they generally cost less than the brand-name prescriptions. Generic medications are just as safe and effective as brand-name medications, so it’s an option worth considering to reduce your cost. Ask your prescriber about switching to a generic version of your medication to save money.

7. Consider lower-cost alternative medications

There may be other medications that help manage your condition, and they may cost less. If your medication is costly or not covered by your insurance, talk to your prescriber about lower-cost alternatives that might be a good option for you. Alternatives might have better insurance coverage or lower costs.

8. Learn more about patient assistance programs

Patient assistance programs (PAPs) offer free or low-cost medications to uninsured and low-income consumers. These programs, which primarily offer savings on brand-name medications, are usually run by private pharmaceutical companies or nonprofit organizations. You must meet certain qualifications and complete paperwork to receive savings from PAPs. However, some PAPs exclude Medicare recipients, so it’s important to review the program’s rules and requirements carefully.

9. Check state-funded resources

Depending on where you live, your state may offer programs to help you navigate prescription medication costs. A good place to start is your local Department of Aging. This U.S. Department of Health and Human Services office can help you find the best Medicare plan for the coverage you need.

Some states even have their own cost-saving programs for older adults. For example, Pennsylvania runs PACE and PACENET. These programs help eligible residents get prescription medications at reduced costs.

Alternatively, you can find out if your state has a State Pharmaceutical Assistance Program by using Medicare’s search tool. These programs are state-run and help qualifying residents pay for prescription medications.

10. Use a health savings account to pay for prescription medications

Although you can’t contribute to a health savings account (HSA) after enrolling in Medicare, you can still use any remaining funds in your account to pay for qualified medical expenses. An HSA allows you to use tax-free dollars to pay for eligible prescription medications. The money in your account does not expire so you can use your funds at any time to reduce your out-of-pocket medication costs.

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Frequently asked questions about Insulin lispro 75/25

Insulin lispro 75/25 is a mixture of two types of insulin within a single product: 75% insulin lispro protamine (an intermediate-acting insulin) and 25% insulin lispro (a rapid-acting insulin). It starts to lower blood sugar levels 15 minutes after injection, each dose can help manage blood sugar levels through two meals, or a meal and a snack. Because of this, Insulin lispro 75/25 is typically injected twice daily.

Insulin lispro in Insulin lispro 75/25 is a fast-acting insulin. It starts to lower blood sugar about 15 minutes after injection, which is why Insulin lispro 75/25 is injected within 15 minutes before a meal. Keep in mind that Insulin lispro 75/25 also contains insulin lispro protamine, which is an intermediate-acting insulin that helps your body manage blood sugar levels over 2 meals.

No, Novolog 70/30 and Insulin lispro 75/25 are two different brands of insulin mixtures, but they're very similar to each other. They both contain a rapid-acting insulin and an intermediate-acting insulin. They're both available as vials and pre-filled pens, and are typically injected twice daily. The main difference is the composition of insulin in each brand. Insulin lispro 75/25 contains 75% insulin lispro protamine (an intermediate-acting insulin) and 25% insulin lispro (a rapid-acting insulin). Novolog 70/30 contains 70% insulin aspart protamine (an intermediate-acting insulin) and 30% insulin aspart (a rapid-acting insulin). Talk with your diabetes care specialist if you have specific questions about each brand.

Insulin lispro 75/25 should be taken within 15 minutes before a meal because it starts to work quickly to lower blood sugar. Taking it too early before a meal can cause hypoglycemia (dangerously low blood sugar).

Yes. Before drawing up a dose, you'll need to gently roll the Insulin lispro 75/25 vial or KwikPen in between your hands at least 10 times. Then, you'll need to move the vial or pen up and down 10 times. This helps mix the Insulin lispro 75/25 suspension so that you can draw up the right dose. After completing these steps, the liquid in the vial or pen should be uniform, white, and cloudy. Don't use it if it looks clear or contains any lumps or particles (solid chunks).

Yes, it's possible to gain weight from Insulin lispro 75/25. This is a typical side effect of insulin because of how it works in your body. In clinical studies, people using Insulin lispro 75/25 for 30 months gained about 12 pounds. But the amount of weight you can gain from insulin typically depends on your insulin dose and your lifestyle habits. To lower your risk for weight gain, your healthcare team can help you plan a nutritious diet and an exercise routine that works best for you. Talk with your healthcare team if you have more questions about the risk of weight gain from Insulin lispro 75/25.

Yes, Insulin lispro 75/25 isn't a type of insulin that's available over the counter; it's only available by a prescription from a healthcare professional.

Yes, Insulin lispro 75/25 can spoil if it's kept past the written expiration date or if it's not stored properly. Store unopened vials and pens in the refrigerator up until their expiration date written on the box or actual product. You can also keep them at room temperature, but only for up to 10 days for the pens and up to 28 days for the vials before they expire. Keep opened pens at room temperature for up to 10 days after opening; don't put them back into the refrigerator. For opened vials, keep them either at room temperature or in the refrigerator for up to 28 days after opening. It's highly recommended you write the new expiration date on the vial or pen so you don't accidentally use an expired medication.