Cost-sharing cap on epinephrine auto-injectors under health insurance policies and plans.
Impact
If enacted, SB935 would amend existing statutes regarding the coverage and cost-sharing of drugs and devices under health insurance policies in Wisconsin. It mandates that health plans cannot set exorbitant costs for essential allergy medications, ensuring that financial barriers do not preclude necessary medical treatment. The provisions of this bill are expected to enhance public health outcomes by making critical medications more affordable and accessible to patients who need them.
Summary
Senate Bill 935, introduced in the Wisconsin Legislature, aims to create a cost-sharing cap on epinephrine auto-injectors. The bill stipulates that all health insurance policies and self-insured health plans covering medically necessary epinephrine auto-injectors cannot impose a cost-sharing amount exceeding $60 for a twin-pack. This initiative is particularly significant for individuals with severe allergies who rely on these devices for emergency treatment, thus aiming to enhance access to vital healthcare products.
Contention
The bill may raise debates regarding the implications for health insurance providers, as they would need to manage cost-sharing arrangements more tightly in relation to epinephrine auto-injectors. Some stakeholders may express concerns about the financial impact on insurance companies and how these changes can affect insurance premiums overall. Additionally, defining which epinephrine auto-injectors are covered under this mandate could also lead to discussions on what constitutes 'medically necessary' which may differ among patients and policies.
Requires health insurance carriers to provide coverage for epinephrine auto-injector devices and asthma inhalers; limits cost sharing for health insurance coverage of insulin.
Requires health insurance carriers to provide coverage for epinephrine auto-injector devices and asthma inhalers; limits cost sharing for health insurance coverage of insulin.