Medica, a Minnesota-based insurance company, has announced that it will cap out-of-pocket costs for insulin to $25 a month for some of its customers. With the announcement, Medica becomes the second insurance company to announce the option of a $25 cap on what customers pay for insulin each month.
According to a StarTribune report, the option will be available to customers who buy individual coverage through Minnesota’s state insurance exchange, as well as to employees of Minnesota-based businesses that opt into the program. This program would not apply to Medicare and Medicaid recipients covered through the insurer.
This move comes after Pennsylvania-based insurer Cigna announced in April that it would also cap out-of-pocket insulin expenses at $25 per month. In May, Colorado became the first state to pass into law a monthly $100 cap on insulin costs for those with insurance.
While the moves by Cigna and the state of Colorado have been applauded by many within the diabetes community, others have pointed out that these measures can’t help those with diabetes who lack insurance, or those on Medicare and Medicaid, to afford the full list price of insulin. Some states have passed laws to create emergency access to insulin in certain situations, but such an emergency insulin access bill was narrowly defeated in Minnesota in May.
Last month, insulin affordability activists traveled with Senator Bernie Sanders (D-VT), a presidential candidate, to Canada for insulin to draw attention to the insulin pricing crisis in the United States.
The affordability of insulin and other diabetes supplies is a widespread concern for many within the type 1 diabetes community. High out-of-pocket costs has caused many to either reduce the amount of insulin they use or make other hard choices to afford the monthly costs of diabetes.
Consider these polls:
-In a November 2018 T1D Exchange Glu poll, some 39% of respondents said they could not at that time afford to pay for a $325 vial of insulin.
-In a separate November 2018 T1D Exchange Glu poll, 16 percent of respondents reported they had reduced the amount of insulin they took due to cost.
-In a March 2019 poll of T1D Exchange Glu users, 60 percent of respondents reported they had shared diabetes supplies with others who couldn’t afford it.
On August 15th, T1D Exchange Glu will ask its members, “When was the last time you didn’t take as much insulin as you should have because you were rationing insulin due to high out-of-pocket costs?” If you wish to take part and are not a member, you can sign up here.