A law signed in 2023 caps out-of-pocket costs for insulin, asthma inhalers, and epinephrine injectors beginning Jan. 1. (Photo Illustration by Spencer Platt/Getty Images)
Health insurance rules capping monthly out-of-pocket costs for insulin, asthma inhalers, and epinephrine injectors took effect on New Year’s Day.
The provisions, required under a law Gov. Phil Murphy signed in July 2023, exempt insulin, asthma inhalers, and epinephrine injectors from insurance plan deductibles and respectively limit copayment or coinsurance costs for the drugs to $35, $50, and $25 for a 30-day supply.
“The cost of staying well and treating a variety of illnesses is just extraordinarily expensive, so anything we can do to keep those prices under control, we can, and we will. Obviously, in this case we have,” said Sen. Joe Vitale (D-Middlesex), who sponsored the law in the upper chamber.
Though signed more than a year ago, the bill did not begin to apply to New Jersey insurance plans until Jan. 1.
In addition to capping prices for some drugs used to treat chronic conditions, the law requires insurance plans approved by state regulators, with some exceptions, to provide coverage for glucose test strips and other items used to manage diabetes.
It also requires plans to cover diabetes self-management training courses if such courses are prescribed by a medical professional.
“The Governor is proud to have signed into law a nation-leading policy to cap the cost of prescription medications for insulin, inhalers, and EpiPens. Along with new laws overseeing the business practices of pharmacy benefit managers and improved transparency across the drug supply chain, this new law will be critical to ensuring New Jersey residents can access life-saving prescription drugs,” said Murphy spokesperson Maggie Garbarino.
Though federal law already capped monthly insulin costs to $35 for some Medicare beneficiaries, New Jersey’s out-of-pocket limit is not restricted by age. Some insulin manufacturers, including Eli Lilly, have voluntarily capped monthly insulin costs.