Insulin copay ban: What it means for New Yorkers
NEW YORK (PIX11) – The new year will bring new changes to the cost of insulin for New Yorkers.
Starting on Jan. 1, New Yorkers on state-regulated insurance plans will no longer have copays for insulin.
State-regulated insurance plans include those purchased on the health insurance marketplace, state employee health benefit plans, Medicaid plans, Child Health Plus, and most plans offered through companies with less than 200 employees.
The new ban on cost-sharing for insulin only applies to prescriptions administered by an in-network provider.
The law, signed by Gov. Kathy Hochul in April, will take effect for any insurance plan issued, renewed, or modified after Jan. 1, 2025. It comes after a previous bill that caped insulin copays at $100 for a 30-day supply.
New York State is the first to ban copays for insulin among 24 other states that have a cap out-of-pocket costs.
Medical expenses for Americans with diabetes is about 2.6 times higher than those without, according to the American Diabetes Association. One in six Americans say they have rationed their insulin due to cost, either taking less than they need or skipping doses.
Advocates from the ADA say the new law will support a healthier future for New Yorkers with diabetes by improving health equity.
Dominique Jack is a digital content producer from Brooklyn with more than five years of experience covering news. She joined PIX11 in 2024. More of her work can be found here.