Blue Cross Minnesota to eliminate insulin co-pays for fully insured members

Blue Cross and Blue Shield of Minnesota jumped into the race to ease consumers' spending on insulin Thursday, announcing new benefits in which members of its fully insured health plans will be able to obtain many forms of insulin with $0 of cost-sharing for 2020.

Eagan-based Blue Cross becomes the third insurer in three weeks to announce changes to its 2020 insulin coverage that are intended to lower out-of-pocket spending on insulin, a potentially lifesaving drug for people with diabetes that can cost members hundreds or even thousands of dollars a year out of pocket.

Insulin is a naturally occurring hormone that regulates blood-glucose levels, and it's also manufactured as a biologic injectable drug for people whose bodies don't produce adequate quantities or don't use it correctly to extract energy from blood sugar. More than 440,000 Minnesotans have diabetes.

On Thursday, Blue Cross said it was ending cost-sharing for insulin covered under its 2020 plans sold to families and individuals on the public MNsure insurance exchange website, as well as small-group and large-group plans that are fully insured by Blue Cross. The changes won't apply to self-insured health plans where Blue Cross works as a third party to administer the company's benefits, unless the client makes arrangements to obtain the new benefit. Larger companies are often self-insured.

Specifically, starting Jan. 1, members in affected Blue Cross plans won't be required to make any co-payments or pay toward their out-of-pocket coinsurance maximums to get insulin at the point of sale when they use insulin listed in Tier 1 or Tier 2 of their plan formulary. Those tiers include generics and some brand-name insulins. The change applies to insulin bought at the pharmacy or received via mail-order. Blue Cross said it is not increasing premiums to cover the new insulin benefit in fully insured plans.

"We felt a responsibility to address the skyrocketing cost of insulin with the options we have available. Hopefully our action will provide some measure of financial relief to many of our members who live with diabetes," said Minnesota Blue Cross CEO Dr. Craig Samitt in a news release.

Earlier this month, Minnetonka-based Medica announced that people who buy its MNsure plans or get fully insured coverage through an employer would have their out-of-pocket spending capped at $25 for a one-month supply of insulin in 2020. A week later, Minneapolis-based UCare announced that its 2020 MNsure plan members would have their monthly expenses for insulin capped at $25, along with getting access to programs that compensate members for buying healthy food and going to the gym.

The changes come at a time of heightened concern over the rising price of insulin.

Minnesota Attorney General Keith Ellison filed an amended lawsuit against the three major insulin manufacturers in April alleging the drugmakers have engaged in deceptive and fraudulent practices to keep prices high, harming consumers and the state. The companies deny wrongdoing. Meanwhile, the state Legislature has been debating a bill intended to make emergency insulin available to people who cannot afford it, though the bill reportedly stalled over disagreements over who should bear its estimated $10 million cost.

Joe Carlson • 612-673-4779