How to pay less for type 2 diabetes medicines

Start with the generic question

NIDDK says most people with type 2 diabetes start with metformin, which helps your liver make less glucose and helps your body use insulin better. Other oral medicines work in different ways, and combining two or three kinds can lower blood glucose better than one (NIDDK).

The FDA says approved generics are bioequivalent to the brand, cost less, and have the same therapeutic effect (FDA). Ask your doctor or pharmacist whether a generic, or a lower-cost medicine in the same class, would work for you.

If you have Medicare

• Negotiated prices. CMS says the negotiated prices for the first 10 selected Part D drugs went into effect on January 1, 2026. The list includes Januvia, Jardiance, Farxiga and NovoLog/Fiasp (CMS, CMS fact sheet). What you pay still depends on your plan.
• The next round. CMS lists 15 drugs for 2027 negotiated prices, including Ozempic, Rybelsus and Wegovy, Janumet and Tradjenta (CMS).
• A yearly cap. Out-of-pocket costs for covered Part D drugs are capped at $2,100 in 2026 and $2,400 in 2027. The deductible can’t be more than $615 in 2026 or $700 in 2027 (Medicare.gov).
• Spread payments out. The Medicare Prescription Payment Plan spreads your out-of-pocket drug costs across the year at no cost to join, but Medicare says it doesn’t lower your drug costs (Medicare.gov).
• Discount cards don’t count. If you buy a drug with a discount card instead of your plan, it doesn’t count toward your out-of-pocket limit (Medicare.gov). During open enrollment, make sure your plan covers your medicines. See our Medicare open enrollment guide.

If you’re uninsured or underinsured

• Compare a discount card price for your generic with what you’d pay elsewhere. See how discount cards work.
• HRSA-funded health centers offer care on a sliding fee based on income. Find one near you.
• Illinois open enrollment for 2027 plans runs November 1, 2026 to January 15, 2027 at Get Covered Illinois.

Be careful with cheap GLP-1 offers

GLP-1 medicines like semaglutide are pricey, so cheap offers online are tempting. The FDA warns that unapproved versions don’t go through FDA review, that it’s aware of counterfeit Ozempic sold in the U.S., and that red flags include prices that seem too good to be true and claims that a compounded drug is the same as an FDA-approved one (FDA). Get GLP-1 medicines with a prescription from a licensed pharmacy.

Using insulin too? See our insulin cost guide. On blood pressure or cholesterol medicines as well? See our generic blood pressure and cholesterol guide.