Two Minnesota Insurers Move to Cap or Eliminate Out-of-Pocket Insulin Costs

Two Minnesota Insurers Move to Cap or Eliminate Out-of-Pocket Insulin Costs

-Craig Idlebrook

Two Minnesota insurer health insurance companies UCare and Blue Cross Blue Shield Minnesota announced that they will cap out-of-pocket insulin costs for their customers. The announcements follow a similar guarantee to cap insulin costs by Medica, which announced a $25 monthly cap for some of its customers in early August. 

UCare’s cap will be implemented on January 1st, 2020, according to a corporate press release. Similarly, Blue Cross announced that on that same date, it will “include both Tier 1 and Tier 2 insulin options as a covered benefit with no member cost-sharing” effectively making insulin free with a $0 co-pay for its members.

“Our first responsibility is to do what we can to improve the health and financial stability of our members,” Dr. Craig Samitt, president and CEO of Blue Cross Minnesota, said in the press release. “We felt a responsibility to address the skyrocketing cost of insulin with the options we have available.  Hopefully our action will provide some measure of financial relief to many of our members who live with diabetes.”

In its announcement, UCare said the move was made possible because of a recent rule change by the Internal Revenue Service that allows insurers to cover the costs of medicine for chronic care in certain high-deductible health plans. for insulin benefits outside of a deductible for certain high-deductible health plans.

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These recent moves are taking place against a backdrop of contentious debate among Minnesota state legislators over legislation to offer emergency access to insulin for those who are underinsured or uninsured – the Alec Smith Emergency Insulin Act. The bill, named after a Minnesota resident who died after he rationed insulin because of cost, was predicted to pass in the last legislative session, but fell a single vote short of passage. 

Outside of Minnesota, the insurer Cigna announced in April that it would also cap out-of-pocket monthly costs to $25 for some of its customers. In May, the Colorado legislature passed a measure that capped out-of-pocket insulin costs at $100 for insured patients.

While these moves may provide some price relief for those covered by the insurance programs, insulin pricing advocates point out that they will not help people who lack insurance, and the proportion of un- and under-insured  American has grown recently after years of decline. In January, Gallup released data that showed the number of uninsured Americans has risen by 7 million since President Trump took office in 2017. 

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