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Humalog Mix is a brand of insulin lispro / insulin lispro protamine, human. What agents check before quoting it: how many 2026 Part D plans cover it, on which tier, with what restrictions and copays, by plan type, carrier and state.
In 2026, 2,124 of 5,496 Medicare Part D and Medicare Advantage drug plans (38.6%) list Humalog Mix on their formulary, across 170 of 328 formularies. The most common placement is tier 3 (1,973 plans, 92.9% of those covering it). 8 of the covering plans require prior authorization (0.4%), 0 step therapy and 378 a quantity limit. Generic insulin lispro is on 4,002 of 5,496 plans (72.8%).
566 covering plans charge a flat copay for a 30-day supply at a preferred retail pharmacy after the deductible — median $45, 66 of them $0; 1,558 charge coinsurance instead — median 20% of the drug's cost. Covered insulin is capped at $35 for a month's supply.
2025: 3,427 of 5,631 plans covered it (60.9%); 2026: 2,124 of 5,496 (38.6%).
Of 4,368 plans offered in both years, 57 added it to the formulary and 906 dropped it.
Among plans covering it both years, 24 moved it to a higher tier and 21 to a lower one; 0 added prior authorization and 0 removed it.
Medicare Part D paid for 277,942 30-day fills of Humalog Mix in 2024 for about 39,232 enrollees, at an average total cost of $187.67 per 30-day fill (CMS Part D Prescribers by Geography and Drug, national).
Price Humalog Mix and the rest of a client's list on every plan in their county.
Estimate Humalog Mix costs by plan
Free tools for licensed insurance agents. Data from CMS public files; verify with plan documents before advising a client.
Counts are over every Medicare Advantage drug plan and stand-alone Part D plan in the CMS monthly formulary files, excluding employer plans. A plan counts as covering a drug when any strength or form of it is on the plan’s formulary; the tier, prior authorization, step therapy and quantity limit shown are the most favorable version on that formulary. Copays are for a 30-day supply at a preferred retail pharmacy after the deductible. This is a reference for licensed agents, not a plan recommendation; verify with the plan’s formulary before advising a client. Source: CMS Part D formulary files (release 09/16/2026). CMS formulary data.