New Law Capping Out-of-Pocket Insulin Costs Took Effect January 1

January 8, 2020

Roughly 1.3 million adults in Illinois have diabetes
Only three new Illinois laws took effect at the start of 2021 due to the COVID-19 pandemic cutting short the spring session of the General Assembly. 

One of the new laws, Public Act 101-0625, amends the Illinois Insurance Code to cap out-of-pocket insulin costs at $100 for a 30-day supply, regardless of how much insulin is needed to fill a prescription. 

Illinois’ new law applies to all patients using a state-regulated commercial insurance plan. Federally regulated plans are not included in the legislation. 

The new law also requires the Illinois Department of Insurance, along with the Department of Human Services and the Department of Healthcare and Family Services, to create a public insulin pricing report. This report will include a summary of insulin pricing practices and public policy recommendations to prevent the overpricing of insulin prescriptions in the future.

If you have questions, please contact the ISMS Health Policy Research and Advocacy team by email.