Insulin costs you $0 on most New York-regulated plans

If you use prescription insulin and have an individual, small-group, or large-group health policy governed by New York insurance law, the insulin itself must be covered without a copay, deductible, coinsurance, or other cost-sharing. You do not apply separately. The law took effect Jan. 1, 2025, as policies were issued or renewed. It covers grandfathered and high-deductible plans, but not individual catastrophic plans.

The law does not govern self-funded employer plans or Medicare. Child Health Plus, Medicaid Managed Care, and the Essential Plan follow separate rules. Medicare has its own cap of no more than $35 for a month’s supply of each covered insulin product.

Before this, the state cap was $100 per 30-day supply for each insulin prescription, so people using more than one insulin drug could owe more than $100 a month. The state said some eligible New Yorkers could save $1,200 a year and projected $14 million in total savings in 2025.

Sen. Gustavo Rivera, then chair of the Senate Health Committee, sponsored the bill that the Senate passed in January 2024 and that was included in the enacted budget. Assembly Member Phara Souffrant Forrest carried its Assembly counterpart. Gov. Kathy Hochul also proposed eliminating insulin cost-sharing in her 2024 State of the State and included it in her executive budget. The Legislature passed the final measure as Part EE of the budget, and Hochul signed it on April 20, 2024.