Nevada caps covered insulin payments at $35 per 30-day supply

Eligible private health plans must cap patients’ payments at $35 for a 30-day supply of each covered prescription insulin drug. The limit covers individual and group insurance and other eligible private health plans. It includes deductibles, copayments, and other amounts patients pay for insulin used to treat type I, type II, or gestational diabetes. The insulin must be prescribed to the patient and covered by the plan, regardless of its amount or type. Health maintenance organizations and managed care organizations are exempt for Medicaid, the Children’s Health Insurance Program, and the listed state and local government employee coverage. The exemptions do not extend to services under other contracts. The law applies to policies issued on or after October 1, 2025, and to renewals or extensions of policies issued before that date.

Nevada’s insurance commissioner may suspend or revoke a health maintenance organization’s permission to operate for failing to follow the insulin payment limit. This authority covers health maintenance organizations whose plans must follow the insulin payment limit. The commissioner must complete the required legal process before suspending or revoking permission to operate.

Nevada’s insurance commissioner may require a Nevada-based insurer’s policy for an out-of-state resident to meet the insulin payment limit. This authority covers policies issued by Nevada-based insurers for delivery to people living in another state. The other state’s insurance official must tell Nevada’s commissioner that the policy is not subject to that official’s approval or disapproval.