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    Home / Pharmacy rules by state / Insulin caps by state

    Insulin copay caps by state: 2026 list

    Checked against each state's rules: October 2026

    Short answer

    As of October 2026, 29 states and Washington, DC cap what state-regulated health plans can charge for insulin, and 21 have no state cap. State caps do not apply to self-funded employer plans, which many large employers use. Separately, Medicare has capped covered insulin at 35 dollars a month since 2023, and the major insulin makers run programs that can limit monthly costs for people with or without insurance.

    Insulin caps in every state

    Each row quotes that state's pharmacy rules guide, which cites the state's own sources and explains which plans the cap applies to. Follow the link for the full rules.

    • Alabama
      Yes, on state-regulated plans
      Alabama caps cost-sharing for insulin on state-regulated health plans at a fixed amount per thirty-day supply under a 2021 law; it does not apply to self-funded employer plans. The federal Medicare Part D insulin cap applies to Part D plans, and manufacturer self-pay programs apply regardless of state.
    • Alaska
      No state cap (federal Medicare cap applies to Part D)
      Alaska had no state insulin copay cap in force when this guide was checked. The federal Medicare Part D insulin cap applies to Part D plans, and manufacturer self-pay programs apply regardless of state.
    • Arizona
      No state cap (federal Medicare cap applies to Part D)
      Arizona had no state insulin copay cap in force when this guide was checked. The federal Medicare Part D insulin cap applies to Part D plans, and manufacturer self-pay programs apply regardless of state.
    • Arkansas
      No state cap (federal Medicare cap applies to Part D)
      Arkansas had no state insulin copay cap in force when this guide was checked. The federal Medicare Part D insulin cap applies to Part D plans, and manufacturer self-pay programs apply regardless of state.
    • California
      Yes, on state-regulated plans
      California caps cost-sharing for insulin on state-regulated health plans at a fixed amount per thirty-day supply under a 2025 law, in force for large-group plans now and for small-group plans from January 2027; it does not apply to self-funded employer plans. The state is also producing its own low-cost insulin through its CalRx program.
    • Colorado
      Yes, on state-regulated plans
      Colorado was the first state to cap insulin cost-sharing on state-regulated health plans, with a collective cap per thirty-day supply in force since 2020; it does not apply to self-funded employer plans or to patients paying cash. Colorado also runs an insulin affordability program that lets eligible residents buy insulin at a set price regardless of insurance; check the state’s page for eligibility.
    • Connecticut
      Yes, on state-regulated plans
      Connecticut caps cost-sharing on state-regulated health plans for a thirty-day supply of insulin or other diabetes medicines at a low fixed amount, and separately caps diabetes devices and supplies, under a 2020 law; it does not apply to self-funded employer plans or to patients paying cash.
    • Delaware
      Yes, on state-regulated plans
      Delaware caps total cost-sharing for insulin on state-regulated health plans at a fixed amount per thirty-day supply, sets no cost-sharing for insulin pumps, and separately caps other diabetes equipment and supplies; the caps do not apply to self-funded employer plans or to patients paying cash.
    • Florida
      No state cap (federal Medicare cap applies to Part D)
      Florida had no state insulin copay cap in force as of this guide’s date. The federal Medicare Part D insulin cap applies to Part D plans, and manufacturer self-pay programs apply regardless of state.
    • Georgia
      No state cap (federal Medicare cap applies to Part D)
      Georgia had no state insulin copay cap in force when this guide was checked. The federal Medicare Part D insulin cap applies to Part D plans, and manufacturer self-pay programs apply regardless of state.
    • Hawaii
      No state cap (federal Medicare cap applies to Part D)
      Hawaii had no state insulin copay cap in force when this guide was checked. The federal Medicare Part D insulin cap applies to Part D plans, and manufacturer self-pay programs apply regardless of state.
    • Idaho
      No state cap (federal Medicare cap applies to Part D)
      Idaho had no state insulin copay cap in force when this guide was checked. The federal Medicare Part D insulin cap applies to Part D plans, and manufacturer self-pay programs apply regardless of state.
    • Illinois
      Yes, on state-regulated plans
      Illinois caps total insulin cost-sharing on state-regulated health plans at a low fixed amount per thirty-day supply, a cap the state lowered by a 2023 law; it does not apply to self-funded employer plans or to patients paying cash. The state also runs an insulin safety-net program for eligible residents facing an emergency need.
    • Indiana
      No state cap (federal Medicare cap applies to Part D)
      Indiana had no state insulin copay cap in force when this guide was checked. The federal Medicare Part D insulin cap applies to Part D plans, and manufacturer self-pay programs apply regardless of state.
    • Iowa
      No state cap (federal Medicare cap applies to Part D)
      Iowa had no state insulin copay cap in force when this guide was checked. The federal Medicare Part D insulin cap applies to Part D plans, and manufacturer self-pay programs apply regardless of state.
    • Kansas
      No state cap (federal Medicare cap applies to Part D)
      Kansas had no state insulin copay cap in force when this guide was checked. The federal Medicare Part D insulin cap applies to Part D plans, and manufacturer self-pay programs apply regardless of state.
    • Kentucky
      Yes, on state-regulated plans
      Kentucky caps cost-sharing for insulin on state-regulated health plans at a fixed amount per thirty-day supply under a 2021 law; it does not apply to self-funded employer plans or to patients paying cash.
    • Louisiana
      Yes, on state-regulated plans
      Louisiana caps cost-sharing for insulin on state-regulated health plans at a fixed amount per thirty-day supply under a 2022 law; it does not apply to self-funded employer plans or to patients paying cash.
    • Maine
      Yes, on state-regulated plans
      Maine caps cost-sharing for insulin on state-regulated health plans at a fixed amount per thirty-day supply under a 2020 law; it does not apply to self-funded employer plans or to patients paying cash.
    • Maryland
      Yes, on state-regulated plans
      Maryland caps cost-sharing for insulin on state-regulated health plans at a fixed amount per thirty-day supply, under a law in force since 2023; it does not apply to self-funded employer plans or to patients paying cash.
    • Massachusetts
      Yes, on state-regulated plans
      Massachusetts caps cost-sharing for insulin on state-regulated health plans at a low fixed amount per thirty-day supply under a 2024 law.
    • Michigan
      No state cap (federal Medicare cap applies to Part D)
      Michigan had no state insulin copay cap in force when this guide was checked, though bills have passed one chamber in past sessions.
    • Minnesota
      Yes, on state-regulated plans
      Minnesota caps monthly cost-sharing for insulin and other diabetes medicines, and separately for diabetes supplies, on state-regulated health plans under a 2023 law; it does not apply to self-funded employer plans or to patients paying cash. Separately, the state’s Insulin Safety Net Program lets eligible residents obtain an emergency thirty-day supply at a pharmacy for a small fee and apply for ongoing supplies through the manufacturers, under its own eligibility rules.
    • Mississippi
      No state cap (federal Medicare cap applies to Part D)
      Mississippi had no state insulin copay cap in force when this guide was checked. The federal Medicare Part D insulin cap applies to Part D plans, and manufacturer self-pay programs apply regardless of state.
    • Missouri
      No state cap (federal Medicare cap applies to Part D)
      Missouri had no state insulin copay cap in force when this guide was checked. The federal Medicare Part D insulin cap applies to Part D plans, and manufacturer self-pay programs apply regardless of state.
    • Montana
      Yes, on state-regulated plans
      Montana caps cost-sharing for insulin on state-regulated health plans at a fixed amount per thirty-day supply; it does not apply to self-funded employer plans or to patients paying cash.
    • Nebraska
      Yes, on state-regulated plans
      Nebraska caps cost-sharing for insulin on state-regulated health plans at a fixed amount per thirty-day supply under a 2023 law; it does not apply to self-funded employer plans or to patients paying cash.
    • Nevada
      Yes, on state-regulated plans
      Nevada caps cost-sharing for insulin on state-regulated health plans at a fixed amount per thirty-day supply under a 2025 law; it does not apply to self-funded employer plans or to patients paying cash.
    • New Hampshire
      Yes, on state-regulated plans
      New Hampshire caps cost-sharing for insulin on state-regulated health plans at a fixed amount per thirty-day supply under a 2020 law; it does not apply to self-funded employer plans or to patients paying cash.
    • New Jersey
      Yes, on state-regulated plans
      New Jersey caps cost-sharing for insulin on state-regulated health plans at a fixed amount per thirty-day supply, and also caps cost-sharing for epinephrine auto-injectors and asthma inhalers, under a law in force since 2024; it does not apply to self-funded employer plans or to patients paying cash.
    • New Mexico
      Yes, on state-regulated plans
      New Mexico caps cost-sharing for insulin on state-regulated health plans at a low fixed amount per thirty-day supply under a 2020 law; it does not apply to self-funded employer plans or to patients paying cash.
    • New York
      Yes: no cost-sharing on state-regulated plans
      New York eliminated patient cost-sharing for insulin on state-regulated health plans under a law effective in 2025, so insured patients on those plans pay nothing at the counter; it does not apply to self-funded employer plans or to patients paying cash.
    • North Carolina
      No state cap (federal Medicare cap applies to Part D)
      North Carolina had no state insulin copay cap in force on commercial plans when this guide was checked, though the State Health Plan for public employees sets its own limits.
    • North Dakota
      Yes, on state-regulated plans
      North Dakota caps cost-sharing for insulin and certain basic diabetes supplies on state-regulated health plans at a low fixed amount per thirty-day supply, under a 2025 law that extended an earlier cap for state employees; it does not apply to self-funded employer plans or to patients paying cash.
    • Ohio
      No state cap (federal Medicare cap applies to Part D)
      Ohio had no state insulin copay cap in force when this guide was checked, though bills have been introduced in several sessions. The federal Medicare Part D insulin cap applies to Part D plans, and manufacturer self-pay programs apply regardless of state.
    • Oklahoma
      Yes, on state-regulated plans
      Oklahoma caps cost-sharing for insulin on state-regulated health plans at a fixed amount per thirty-day supply, with a matching cap for a ninety-day supply, under a 2021 law; it does not apply to self-funded employer plans or to patients paying cash.
    • Oregon
      Yes, on state-regulated plans
      Oregon caps cost-sharing for insulin on state-regulated health plans at a fixed amount per thirty-day supply, with a matching cap for a ninety-day supply, under a 2024 law; it does not apply to self-funded employer plans or to patients paying cash.
    • Pennsylvania
      No state cap (federal Medicare cap applies to Part D)
      Pennsylvania had no state insulin copay cap in force as of this guide’s date, though bills have been introduced.
    • Rhode Island
      Yes, on state-regulated plans
      Rhode Island caps cost-sharing for insulin on state-regulated health plans at a fixed amount per thirty-day supply under a 2021 law; it does not apply to self-funded employer plans or to patients paying cash.
    • South Carolina
      No state cap (federal Medicare cap applies to Part D)
      South Carolina had no state insulin copay cap in force when this guide was checked. The federal Medicare Part D insulin cap applies to Part D plans, and manufacturer self-pay programs apply regardless of state.
    • South Dakota
      No state cap (federal Medicare cap applies to Part D)
      South Dakota had no state insulin copay cap in force when this guide was checked. The federal Medicare Part D insulin cap applies to Part D plans, and manufacturer self-pay programs apply regardless of state.
    • Tennessee
      No state cap (federal Medicare cap applies to Part D)
      Tennessee had no state insulin copay cap in force when this guide was checked. The federal Medicare Part D insulin cap applies to Part D plans, and manufacturer self-pay programs apply regardless of state.
    • Texas
      Yes, on state-regulated plans
      Texas caps insulin cost-sharing on state-regulated health plans at a set amount per thirty-day supply, under a law in force since 2022; it does not apply to self-funded employer plans, which are federally regulated, or to patients paying cash.
    • Utah
      Yes, on state-regulated plans
      Utah caps cost-sharing for insulin on state-regulated health plans at a fixed amount per thirty-day supply under a 2020 law; it does not apply to self-funded employer plans or to patients paying cash.
    • Vermont
      Yes, on state-regulated plans
      Vermont caps total cost-sharing for insulin on state-regulated health plans at a fixed collective amount per thirty-day supply; it does not apply to self-funded employer plans or to patients paying cash.
    • Virginia
      Yes, on state-regulated plans
      Virginia caps cost-sharing for insulin on state-regulated health plans at a fixed amount per thirty-day supply, under a law in force since 2021 and lowered since; it does not apply to self-funded employer plans or to patients paying cash.
    • Washington
      Yes, on state-regulated plans
      Washington caps cost-sharing for insulin on state-regulated health plans at a low fixed amount per thirty-day supply, lowered in 2023 from the original cap; it does not apply to self-funded employer plans or to patients paying cash.
    • Washington, D.C.
      Yes, on state-regulated plans
      The District caps cost-sharing for insulin on the health plans it regulates at a low fixed amount per thirty-day supply, and separately caps covered diabetes devices; the caps do not apply to self-funded employer plans, federal employee plans or patients paying cash.
    • West Virginia
      Yes, on state-regulated plans
      West Virginia caps total cost-sharing for insulin on state-regulated health plans at a fixed amount per thirty-day supply, and separately caps diabetes equipment and supplies, under a 2023 law; it does not apply to self-funded employer plans or to patients paying cash.
    • Wisconsin
      No state cap (federal Medicare cap applies to Part D)
      Wisconsin had no state insulin copay cap in force when this guide was checked, though bills have been introduced. The federal Medicare Part D insulin cap applies to Part D plans, and manufacturer self-pay programs apply regardless of state.
    • Wyoming
      No state cap (federal Medicare cap applies to Part D)
      Wyoming had no state insulin copay cap in force when this guide was checked. The federal Medicare Part D insulin cap applies to Part D plans, and manufacturer self-pay programs apply regardless of state.
    State insulin cost-sharing caps, October 2026
    StateState capWhat the state guide says
    AlabamaYes, on state-regulated plansAlabama caps cost-sharing for insulin on state-regulated health plans at a fixed amount per thirty-day supply under a 2021 law; it does not apply to self-funded employer plans. The federal Medicare Part D insulin cap applies to Part D plans, and manufacturer self-pay programs apply regardless of state.
    AlaskaNo state cap (federal Medicare cap applies to Part D)Alaska had no state insulin copay cap in force when this guide was checked. The federal Medicare Part D insulin cap applies to Part D plans, and manufacturer self-pay programs apply regardless of state.
    ArizonaNo state cap (federal Medicare cap applies to Part D)Arizona had no state insulin copay cap in force when this guide was checked. The federal Medicare Part D insulin cap applies to Part D plans, and manufacturer self-pay programs apply regardless of state.
    ArkansasNo state cap (federal Medicare cap applies to Part D)Arkansas had no state insulin copay cap in force when this guide was checked. The federal Medicare Part D insulin cap applies to Part D plans, and manufacturer self-pay programs apply regardless of state.
    CaliforniaYes, on state-regulated plansCalifornia caps cost-sharing for insulin on state-regulated health plans at a fixed amount per thirty-day supply under a 2025 law, in force for large-group plans now and for small-group plans from January 2027; it does not apply to self-funded employer plans. The state is also producing its own low-cost insulin through its CalRx program.
    ColoradoYes, on state-regulated plansColorado was the first state to cap insulin cost-sharing on state-regulated health plans, with a collective cap per thirty-day supply in force since 2020; it does not apply to self-funded employer plans or to patients paying cash. Colorado also runs an insulin affordability program that lets eligible residents buy insulin at a set price regardless of insurance; check the state’s page for eligibility.
    ConnecticutYes, on state-regulated plansConnecticut caps cost-sharing on state-regulated health plans for a thirty-day supply of insulin or other diabetes medicines at a low fixed amount, and separately caps diabetes devices and supplies, under a 2020 law; it does not apply to self-funded employer plans or to patients paying cash.
    DelawareYes, on state-regulated plansDelaware caps total cost-sharing for insulin on state-regulated health plans at a fixed amount per thirty-day supply, sets no cost-sharing for insulin pumps, and separately caps other diabetes equipment and supplies; the caps do not apply to self-funded employer plans or to patients paying cash.
    FloridaNo state cap (federal Medicare cap applies to Part D)Florida had no state insulin copay cap in force as of this guide’s date. The federal Medicare Part D insulin cap applies to Part D plans, and manufacturer self-pay programs apply regardless of state.
    GeorgiaNo state cap (federal Medicare cap applies to Part D)Georgia had no state insulin copay cap in force when this guide was checked. The federal Medicare Part D insulin cap applies to Part D plans, and manufacturer self-pay programs apply regardless of state.
    HawaiiNo state cap (federal Medicare cap applies to Part D)Hawaii had no state insulin copay cap in force when this guide was checked. The federal Medicare Part D insulin cap applies to Part D plans, and manufacturer self-pay programs apply regardless of state.
    IdahoNo state cap (federal Medicare cap applies to Part D)Idaho had no state insulin copay cap in force when this guide was checked. The federal Medicare Part D insulin cap applies to Part D plans, and manufacturer self-pay programs apply regardless of state.
    IllinoisYes, on state-regulated plansIllinois caps total insulin cost-sharing on state-regulated health plans at a low fixed amount per thirty-day supply, a cap the state lowered by a 2023 law; it does not apply to self-funded employer plans or to patients paying cash. The state also runs an insulin safety-net program for eligible residents facing an emergency need.
    IndianaNo state cap (federal Medicare cap applies to Part D)Indiana had no state insulin copay cap in force when this guide was checked. The federal Medicare Part D insulin cap applies to Part D plans, and manufacturer self-pay programs apply regardless of state.
    IowaNo state cap (federal Medicare cap applies to Part D)Iowa had no state insulin copay cap in force when this guide was checked. The federal Medicare Part D insulin cap applies to Part D plans, and manufacturer self-pay programs apply regardless of state.
    KansasNo state cap (federal Medicare cap applies to Part D)Kansas had no state insulin copay cap in force when this guide was checked. The federal Medicare Part D insulin cap applies to Part D plans, and manufacturer self-pay programs apply regardless of state.
    KentuckyYes, on state-regulated plansKentucky caps cost-sharing for insulin on state-regulated health plans at a fixed amount per thirty-day supply under a 2021 law; it does not apply to self-funded employer plans or to patients paying cash.
    LouisianaYes, on state-regulated plansLouisiana caps cost-sharing for insulin on state-regulated health plans at a fixed amount per thirty-day supply under a 2022 law; it does not apply to self-funded employer plans or to patients paying cash.
    MaineYes, on state-regulated plansMaine caps cost-sharing for insulin on state-regulated health plans at a fixed amount per thirty-day supply under a 2020 law; it does not apply to self-funded employer plans or to patients paying cash.
    MarylandYes, on state-regulated plansMaryland caps cost-sharing for insulin on state-regulated health plans at a fixed amount per thirty-day supply, under a law in force since 2023; it does not apply to self-funded employer plans or to patients paying cash.
    MassachusettsYes, on state-regulated plansMassachusetts caps cost-sharing for insulin on state-regulated health plans at a low fixed amount per thirty-day supply under a 2024 law.
    MichiganNo state cap (federal Medicare cap applies to Part D)Michigan had no state insulin copay cap in force when this guide was checked, though bills have passed one chamber in past sessions.
    MinnesotaYes, on state-regulated plansMinnesota caps monthly cost-sharing for insulin and other diabetes medicines, and separately for diabetes supplies, on state-regulated health plans under a 2023 law; it does not apply to self-funded employer plans or to patients paying cash. Separately, the state’s Insulin Safety Net Program lets eligible residents obtain an emergency thirty-day supply at a pharmacy for a small fee and apply for ongoing supplies through the manufacturers, under its own eligibility rules.
    MississippiNo state cap (federal Medicare cap applies to Part D)Mississippi had no state insulin copay cap in force when this guide was checked. The federal Medicare Part D insulin cap applies to Part D plans, and manufacturer self-pay programs apply regardless of state.
    MissouriNo state cap (federal Medicare cap applies to Part D)Missouri had no state insulin copay cap in force when this guide was checked. The federal Medicare Part D insulin cap applies to Part D plans, and manufacturer self-pay programs apply regardless of state.
    MontanaYes, on state-regulated plansMontana caps cost-sharing for insulin on state-regulated health plans at a fixed amount per thirty-day supply; it does not apply to self-funded employer plans or to patients paying cash.
    NebraskaYes, on state-regulated plansNebraska caps cost-sharing for insulin on state-regulated health plans at a fixed amount per thirty-day supply under a 2023 law; it does not apply to self-funded employer plans or to patients paying cash.
    NevadaYes, on state-regulated plansNevada caps cost-sharing for insulin on state-regulated health plans at a fixed amount per thirty-day supply under a 2025 law; it does not apply to self-funded employer plans or to patients paying cash.
    New HampshireYes, on state-regulated plansNew Hampshire caps cost-sharing for insulin on state-regulated health plans at a fixed amount per thirty-day supply under a 2020 law; it does not apply to self-funded employer plans or to patients paying cash.
    New JerseyYes, on state-regulated plansNew Jersey caps cost-sharing for insulin on state-regulated health plans at a fixed amount per thirty-day supply, and also caps cost-sharing for epinephrine auto-injectors and asthma inhalers, under a law in force since 2024; it does not apply to self-funded employer plans or to patients paying cash.
    New MexicoYes, on state-regulated plansNew Mexico caps cost-sharing for insulin on state-regulated health plans at a low fixed amount per thirty-day supply under a 2020 law; it does not apply to self-funded employer plans or to patients paying cash.
    New YorkYes: no cost-sharing on state-regulated plansNew York eliminated patient cost-sharing for insulin on state-regulated health plans under a law effective in 2025, so insured patients on those plans pay nothing at the counter; it does not apply to self-funded employer plans or to patients paying cash.
    North CarolinaNo state cap (federal Medicare cap applies to Part D)North Carolina had no state insulin copay cap in force on commercial plans when this guide was checked, though the State Health Plan for public employees sets its own limits.
    North DakotaYes, on state-regulated plansNorth Dakota caps cost-sharing for insulin and certain basic diabetes supplies on state-regulated health plans at a low fixed amount per thirty-day supply, under a 2025 law that extended an earlier cap for state employees; it does not apply to self-funded employer plans or to patients paying cash.
    OhioNo state cap (federal Medicare cap applies to Part D)Ohio had no state insulin copay cap in force when this guide was checked, though bills have been introduced in several sessions. The federal Medicare Part D insulin cap applies to Part D plans, and manufacturer self-pay programs apply regardless of state.
    OklahomaYes, on state-regulated plansOklahoma caps cost-sharing for insulin on state-regulated health plans at a fixed amount per thirty-day supply, with a matching cap for a ninety-day supply, under a 2021 law; it does not apply to self-funded employer plans or to patients paying cash.
    OregonYes, on state-regulated plansOregon caps cost-sharing for insulin on state-regulated health plans at a fixed amount per thirty-day supply, with a matching cap for a ninety-day supply, under a 2024 law; it does not apply to self-funded employer plans or to patients paying cash.
    PennsylvaniaNo state cap (federal Medicare cap applies to Part D)Pennsylvania had no state insulin copay cap in force as of this guide’s date, though bills have been introduced.
    Rhode IslandYes, on state-regulated plansRhode Island caps cost-sharing for insulin on state-regulated health plans at a fixed amount per thirty-day supply under a 2021 law; it does not apply to self-funded employer plans or to patients paying cash.
    South CarolinaNo state cap (federal Medicare cap applies to Part D)South Carolina had no state insulin copay cap in force when this guide was checked. The federal Medicare Part D insulin cap applies to Part D plans, and manufacturer self-pay programs apply regardless of state.
    South DakotaNo state cap (federal Medicare cap applies to Part D)South Dakota had no state insulin copay cap in force when this guide was checked. The federal Medicare Part D insulin cap applies to Part D plans, and manufacturer self-pay programs apply regardless of state.
    TennesseeNo state cap (federal Medicare cap applies to Part D)Tennessee had no state insulin copay cap in force when this guide was checked. The federal Medicare Part D insulin cap applies to Part D plans, and manufacturer self-pay programs apply regardless of state.
    TexasYes, on state-regulated plansTexas caps insulin cost-sharing on state-regulated health plans at a set amount per thirty-day supply, under a law in force since 2022; it does not apply to self-funded employer plans, which are federally regulated, or to patients paying cash.
    UtahYes, on state-regulated plansUtah caps cost-sharing for insulin on state-regulated health plans at a fixed amount per thirty-day supply under a 2020 law; it does not apply to self-funded employer plans or to patients paying cash.
    VermontYes, on state-regulated plansVermont caps total cost-sharing for insulin on state-regulated health plans at a fixed collective amount per thirty-day supply; it does not apply to self-funded employer plans or to patients paying cash.
    VirginiaYes, on state-regulated plansVirginia caps cost-sharing for insulin on state-regulated health plans at a fixed amount per thirty-day supply, under a law in force since 2021 and lowered since; it does not apply to self-funded employer plans or to patients paying cash.
    WashingtonYes, on state-regulated plansWashington caps cost-sharing for insulin on state-regulated health plans at a low fixed amount per thirty-day supply, lowered in 2023 from the original cap; it does not apply to self-funded employer plans or to patients paying cash.
    Washington, D.C.Yes, on state-regulated plansThe District caps cost-sharing for insulin on the health plans it regulates at a low fixed amount per thirty-day supply, and separately caps covered diabetes devices; the caps do not apply to self-funded employer plans, federal employee plans or patients paying cash.
    West VirginiaYes, on state-regulated plansWest Virginia caps total cost-sharing for insulin on state-regulated health plans at a fixed amount per thirty-day supply, and separately caps diabetes equipment and supplies, under a 2023 law; it does not apply to self-funded employer plans or to patients paying cash.
    WisconsinNo state cap (federal Medicare cap applies to Part D)Wisconsin had no state insulin copay cap in force when this guide was checked, though bills have been introduced. The federal Medicare Part D insulin cap applies to Part D plans, and manufacturer self-pay programs apply regardless of state.
    WyomingNo state cap (federal Medicare cap applies to Part D)Wyoming had no state insulin copay cap in force when this guide was checked. The federal Medicare Part D insulin cap applies to Part D plans, and manufacturer self-pay programs apply regardless of state.

    Which plans a state cap covers

    A state insulin cap applies to health plans the state regulates: individual plans bought through the marketplace or directly from an insurer, and small-group and large-group plans that an employer buys from an insurance company. It does not apply to self-funded employer plans, where the employer pays claims itself and a federal law, ERISA, keeps state insurance rules out. Many large employers are self-funded, so living in a state with a cap does not guarantee your plan follows it.

    To find out which kind you have, look for "self-funded" or "self-insured" on your plan documents or ask your employer’s benefits team. Marketplace plans are always state-regulated.

    If you have Medicare

    Since 2023, Medicare limits what you pay for a month’s supply of each covered insulin to 35 dollars, in Part D plans and, for insulin used with a pump, in Part B. The cap applies whatever your income and in every state, and the Part D deductible does not apply to covered insulin.

    If no cap applies to you

    • Ask about the insulin maker’s savings program; Lilly, Novo Nordisk and Sanofi each offer programs that can limit monthly costs for many people with commercial insurance or none, with terms that vary.
    • Ask whether a lower-list-price unbranded version of your insulin is available, such as Insulin Lispro or Insulin Aspart, which are the same insulins as Humalog and NovoLog.
    • Compare pharmacy cash prices and plan prices; the difference between pharmacies can be large.
    • Older human insulins are sold without a prescription, but they act differently from modern insulins, so change insulin only with your clinician.

    Paying for insulin and supplies

    Some state caps also cover insulin supplies such as pen needles or syringes, and a few cover other diabetes equipment; the state guide says what each includes. On Script Unlock, licensed pharmacies quote their own cash price for your prescription, which helps when no cap applies. Our insulin glargine guide covers taking it, storage and the open-pen rules.

    Frequently asked questions

    Which states cap insulin copays?

    As of October 2026, 29 states and Washington, DC. The table lists every state and links to its guide.

    Does my state’s cap apply to my employer plan?

    Only if the plan is state-regulated. Self-funded employer plans are exempt from state insurance rules under federal law, so ask your benefits team which kind you have.

    Is there a federal insulin cap?

    For Medicare, yes: covered insulin costs no more than 35 dollars a month in Part D and Part B. There is no federal cap for commercial insurance.

    Does the cap cover pens and supplies?

    It depends on the state. Some caps cover insulin supplies as well as insulin; the state guides say what each covers.

    What if I have no insurance?

    State caps apply to insurance plans, so they do not help directly. The insulin makers’ savings programs, unbranded insulins and comparing pharmacy prices are the main routes.

    Related

    • Pharmacy rules by state
    • Insulin glargine guide
    • Insulin lispro guide
    • Medicare Part D guide
    • Type 2 diabetes medications
    • Cash pay vs insurance

    Sources

    • Medicare.gov, insulin coverage
    • American Diabetes Association, affordable insulin resources
    • Each state’s guide, linked in the table, lists that state’s insurance law and sources.
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