State law · insulin cost sharing
State insulin copay caps, as the statutes state them
One card per state we could read from a primary page: the cap and the period it covers, the plan types the statute names and the sentence we quoted, with a link to the statute. Only states we read are listed, and absence is not a claim that a state has no law. For drug prices see the negotiated drug pages.
Caps by state
Each cap is the figure in the quoted sentence. Quotes are shown as read, capitalised as the source capitalises them where it does.
| State | Cap | Plan types the statute names | Also stated | Statute sentence, quoted | Source |
|---|---|---|---|---|---|
| Colorado | $100 per 30-day supply | health coverage plans offered by a carrier | Nothing further in the sentence we quoted. | “A CARRIER THAT PROVIDES COVERAGE FOR PRESCRIPTION INSULIN DRUGS PURSUANT TO THE TERMS OF A HEALTH COVERAGE PLAN THE CARRIER OFFERS SHALL CAP THE TOTAL AMOUNT THAT A COVERED PERSON IS REQUIRED TO PAY FOR A COVERED PRESCRIPTION INSULIN DRUG AT AN AMOUNT NOT TO EXCEED ONE HUNDRED DOLLARS PER THIRTY-DAY SUPPLY OF INSULIN” | C.R.S. 10-16-151 as added by HB19-1216session law as enacted (signed bill); read November 7, 2026Statute text |
| Delaware | $100 per month | individual health insurance policy, contract, or certificate | Nothing further in the sentence we quoted. | “Cap the total amount that a covered individual is required to pay for covered prescription insulin drugs at no more than $100 per month for each enrolled individual” | 18 Del. C. 3344Bcurrent codified statute; read November 7, 2026Statute text |
| Kentucky | $30 per 30-day supply | health benefit plans issued or renewed on or after January 1, 2022 | Effective January 1, 2022 for plans issued or renewed on or after that date. Excludes: self-insured governmental plans (except as provided in KRS 18A.225). | “Cost sharing for a covered prescription insulin drug shall not exceed thirty dollars ($30) per thirty (30) day supply of each prescription insulin drug” | KRS 304.17A-148(3)(b)current codified statute; read November 7, 2026Statute text |
| Louisiana | $75 per prescription for a thirty-day supply | health coverage plan, defined to include group insurance plans, self-insurance plans and the Office of Group Benefits programs | The cap rises each year with a price index. | “A health coverage plan shall not impose a cost-sharing provision for insulin in the health coverage plan's formulary as prescribed in Subsection C of this Section if the total amount the enrollee is required to pay exceeds seventy-five dollars per prescription for a thirty-day supply, regardless of the amount or type of insulin needed to fill the enrollee's prescription.” | La. R.S. 22:1034.1(B)current codified statute; read November 7, 2026Statute text |
| Maine | $35 per prescription for a 30-day supply | coverage provided by a carrier for prescription insulin drugs | Nothing further in the sentence we quoted. | “A carrier that provides coverage for prescription insulin drugs may not impose any deductible, copayment, coinsurance or other cost-sharing requirement on an enrollee for that coverage that results in out-of-pocket costs to the enrollee that exceed $35 per prescription for a 30-day supply of covered prescription insulin drugs” | 24-A M.R.S. 4317-C(2)current codified statute; read November 7, 2026Statute text |
| Maryland | $30 per 30-day supply | insurers and nonprofit health service plans (individual or group policies delivered in the State); health maintenance organizations (contracts issued or delivered in the State) | Nothing further in the sentence we quoted. | “An entity subject to this section shall limit the amount a covered individual is required to pay in copayments or coinsurance for a covered prescription insulin drug to not more than $30 for a 30-day supply, regardless of the amount or type of insulin needed to fill the covered individual's prescription” | Md. Code, Insurance 15-822.1(b)current codified statute; read November 7, 2026Statute text |
| Massachusetts | $25 per 30-day supply | individual or group hospital service plan contracts (M.G.L. c. 176A s. 8DDD) | The statute also bars a deductible for this coverage. Scope limit stated: one brand name insulin drug per dosage and type. | “Coverage for 1 brand name insulin drug per dosage and type, including rapid-acting, short-acting, intermediate-acting, long-acting, ultra long-acting and premixed under this section shall not be subject to any deductible or co-insurance and any co-payment shall not exceed $25 per 30-day supply.” | M.G.L. c. 176A s. 8DDD(d)current codified statute; read November 7, 2026Statute text |
| Minnesota | $25 per one-month supply | health plan | This statute caps prescription drugs for chronic disease generally, not insulin alone. Related supplies: $50 per month. | “A health plan must limit the amount of any enrollee cost-sharing for prescription drugs prescribed to treat a chronic disease to no more than: (1) $25 per one-month supply for each prescription drug, regardless of the amount or type of medication required to fill the prescription” | Minn. Stat. 62Q.481current codified statute; read November 7, 2026Statute text |
| Nevada | $35 per 30-day supply | policy of health insurance offered or issued by an insurer (NRS chapter 689A) | Nothing further in the sentence we quoted. | “An insurer that offers or issues a policy of health insurance which provides coverage for prescription insulin drugs shall not impose against an insured a deductible, copayment, coinsurance or other cost-sharing obligation that is greater than $35 for a 30-day supply of a prescription insulin drug” | NRS 689A.040485current codified statute; read November 7, 2026Statute text |
| New Hampshire | $30 per 30-day supply | insurer that provides coverage for prescription insulin drugs (RSA 415:6-e) | Nothing further in the sentence we quoted. | “Each insurer that provides coverage for prescription insulin drugs shall cap the total amount that a covered person is required to pay for each covered insulin drug prescription at an amount not to exceed $30 for each 30-day supply of each insulin prescription” | RSA 415:6-ecurrent codified statute; read November 7, 2026Statute text |
| New Jersey | $35 per 30-day supply | individual health benefits plan (C.17B:27A-7.31); small employer health benefits plan (C.17B:27A-19.35); State Health Benefits Commission contracts (C.52:14-17.29kk); other individual and group contract types amended by the same act | The statute also bars a deductible for this coverage. | “Coverage for the purchase of a shortacting, intermediate-acting, rapid-acting, long-acting, and pre-mixed insulin product shall not be subject to any deductible, and no copayment or coinsurance for the purchase of insulin shall exceed $35 per 30-day supply” | P.L. 2023, c. 105session law as enacted; read November 7, 2026Statute text |
| Oregon | $35 per 30-day supply | health benefit plan offered in this state (ORS 743B.005) | The statute also bars a deductible for this coverage. It also states $105 for a 90-day supply. | “A health benefit plan offered in this state may not require an enrollee in the plan to incur cost-sharing or other out-of-pocket costs that exceed $35 for each 30-day supply of a type of insulin prescribed for the treatment of diabetes or $105 for each 90-day supply.” | ORS 743A.069(2)current codified statute; read November 7, 2026Statute text |
| Rhode Island | $40 per 30-day supply | health plan that provides coverage for prescription insulin drugs | The statute also bars a deductible for this coverage. Effective January 1, 2022 for plans issued or renewed on or after that date. | “shall cap the total amount that a covered person is required to pay for a covered prescription insulin drug at an amount not to exceed forty dollars ($40.00), per thirty-day (30) supply of insulin” | R.I. Gen. Laws 27-20.8-3(b)current codified statute; read November 7, 2026Statute text |
| Virginia | $35 per 30-day supply | every health plan offered by a carrier (health benefit plan as defined in 38.2-3438) | The cap applies in aggregate when a person is prescribed more than one insulin drug. | “Every health plan offered by a carrier shall set the cost-sharing payment that a covered person is required to pay for a covered prescription insulin drug at an amount that does not exceed $35 in aggregate, including situations where the covered person is prescribed more than one insulin drug, per 30-day supply of the prescription insulin drug” | Va. Code 38.2-3407.15:5current codified statute; read November 7, 2026Statute text |
| Washington | $35 per 30-day supply | health plan issued or renewed | The statute also bars a deductible for this coverage. Effective January 1, 2023 for plans issued or renewed on or after that date. | “a health plan issued or renewed on or after January 1, 2023, that provides coverage for prescription insulin drugs for the treatment of diabetes must cap the total amount that an enrollee is required to pay for a covered insulin drug at an amount not to exceed $35 per 30-day supply of the drug” | RCW 48.43.780(1)(a)current codified statute; read November 7, 2026Statute text |
| West Virginia | $35 per 30-day supply | insurers subject to W. Va. Code 33-15, 33-16, 33-24, 33-25 and 33-25A, as the section cites them | The cap applies in aggregate when a person is prescribed more than one insulin drug. Related devices: $100. | “Cost sharing for a 30-day supply of a covered prescription insulin drug may not exceed $35 in aggregate, including situations where the covered person is prescribed more than one insulin drug, per 30-day supply” | W. Va. Code 33-59-1(e)current codified statute; read November 7, 2026Statute text |
16 states listed. A state that is not listed is a state we have not read, not a state without a law. Not legal advice.
Questions
Is my state missing because it has no insulin cap?
No. Only 16 states we could read from a primary state page appear here. A state that is not listed may have a cap we have not read yet, so absence on this page is not a claim that there is no law.
Does the cap apply to my plan?
Each row lists the plan types the statute names. Whether a particular plan is covered is for the plan or your state insurance department to say; a cap is a limit on cost sharing under the law, not a promise about any plan.
Is the cap the price of insulin?
No. It limits what a covered person can be required to pay under a covered plan for a stated period. It is not the list price, the pharmacy price or the price without insurance.
For developers: state insulin caps as data
One file with a row per state we read: the cap, its period, the plan types, the quoted statute sentence, the source link and a receipt for each fact. A state missing from the file is unread, not a state without a law.
Example file: https://omnirx.org/api/v1/states/insulin-caps.json
The licence page sets out what a data licence covers, and the API page documents these files.
Evaluation files with receipts; contract may change; not clinical advice.
Sources and terms. State statutes and session laws read on each state's own legislative page, quoted briefly with the link; government edicts are not copyrightable, and each state's site terms were not read, so annotations are never taken. Library edition 2026-11. Every figure is stored with its source and date in the OmniRx library: see where every figure comes from. Not medical, legal or financial advice. Licence the data.