How to Advocate for Yourself at the Pharmacy: A Guide for Accessing Insulin

Imagine—you’re at the pharmacy counter, ready to pick up your insulin, and the pharmacist says, “That’ll be $500.” Before the panic sets in, know that there may be ways to reduce costs now.

First, take a deep breath. Then, ask your pharmacist a few questions:

Can I use a cost-savings program or copay card? 

The answer is: yes! All insulin brands and types have Patient Assistance Programs (PAPs) and almost all have copay cards or other cost-savings programs.

To determine what savings options you qualify for, go to GetInsulin.org and enter some basic information to receive an action plan that will include all programs and options available to you, including follow up links, phone numbers to call for help and other needed information.

Patient Assistance Programs cover the full cost of your insulin needs for 12 months if you qualify. They typically work for people who do not have health insurance. The insulin PAPs included below require that you make less income each year than 400% of the Federal Poverty Level (other brand and medication PAP income requirements can vary). In 2025, that means if you are uninsured and make less than $60,240 per year as an individual or $124,800 per year for a family of four, you may qualify. Paperwork and doctor’s signatures are required, so it will take some time to enroll.

Copay cards and cost-savings programs are available in almost all situations, with some that work for those with insurance and others that work for people without insurance, or people with diabetes (PWD) who are paying cash because their insurance does not lower the cost enough. Go to GetInsulin.org for a simple list of programs that work for your insulin needs, or visit:

• Eli Lilly, Insulin Value Program: All Lilly insulins are available for $35/month for U.S. residents with commercial insurance or no insurance.
• MannKind Afrezza Savings Program: PWD with insurance coverage can pay $35 for a monthly supply of Afrezza inhaled insulin.
• MannKind Afrezza Direct Purchase Program: Eligible PWD whose insurance does not cover Afrezza or who are paying cash can pay $99 per month.
• Novo Nordisk, MyInsulinRx™: Eligible PWD can pay $35 for a monthly supply, up to three vials or two packs of pens.
• Novo Nordisk, Copay Savings Cards: For many products, commercially insured PWD may pay as little as $35 per 30-day supply. Terms apply.
• Sanofi, Insulins Valyou Savings Program: Uninsured or cash-pay PWD may pay $35 per 30-day supply of certain Sanofi insulins (must fill all Sanofi insulin scripts together each month; see terms).
• Sanofi, Expanded $35 Access: Starting January 1, 2026, Sanofi will roll out an expanded access program, allowing all U.S. PWD to obtain its insulins for $35/month.
• Sanofi, Copay Assistance: Eligible, commercially insured patients may pay no more than $35 for certain products like—Toujeo, Soliqua, Lantus and Apidra—with a copay card.

Is my insurance kicking in on this prescription? 

If you have insurance coverage that normally covers your insulin but doesn’t seem to be working this time, there could be a few things happening.

• Is it the start of a new calendar year? If you are picking up your insulin for the first time in the new year and facing a high cost, you may have a High Deductible Health Plan, a.k.a. a type of insurance coverage that requires you to pay 100% of the cost for healthcare, including medications, until you hit your deductible.
  
  Copay cards and other insulin cost savings programs will work during this period of time—visit GetInsulin.org to find your best options.

• Do I need prior authorization? If you recently changed what kind of insulin you are using, you may need to call your insurance to see if you need your doctor to file a prior authorization.
  
  You may also need a prior authorization if you are using your same insulin as always, but your insurance company changed their prescription drug formulary, a.k.a. the brands and types of medications they choose to cover. This can happen in January and July of every year.
  
  Getting a prior authorization approved can take weeks or months, so if your insurance company says this is needed, go ahead and start the process now.

• Will my insurance cover a similar type of insulin? If your healthcare provider recommends it, you may also be able to use an alternative insulin type that works the same way, but is made by a brand that your insurance company covers. This is called non-medical switching and is frustrating, but may help lower your costs.

Does my state have an insulin copay cap and do I qualify? 

Since late 2025, 29 U.S. states and the District of Columbia have passed insulin copay price caps, limiting the monthly cost somewhere between $25 and $100 for a 30-day supply. However, most copay price caps only apply to state-regulated insurance plans and do not apply to people who are uninsured or are using self-funded employer plans. The American Diabetes Association (ADA) has published a guide on state-based price caps with links that explain each bill. 

It’s Okay to Be Tired of This

You shouldn’t have to run through hoops to align your diabetes care to your needs, but this is the reality for many Americans. Heading to the pharmacy isn’t as simple as it sounds when you live with diabetes.

Figuring this all out is exhausting. It’s okay to be tired. While challenging the price at the pharmacy counter may feel confrontational, remember that not all confrontation is negative. It’s about how you show up, and you’re showing up for number one—yourself! 

This is about self-advocacy. Today’s day and age calls for it. In life with diabetes, you’ve managed harder things. You can manage the pharmacy counter, and you’re not alone.