UCare is second insurer in Minnesota to unveil $25 cap for insulin

The Minneapolis-based health plan's move comes on heels of similar Medica benefit.

August 15, 2019 at 2:20AM
A patient holds a vial of insulin during a news conference outside a Windor, Ont. pharmacy on July 28, 2019. (AP Photo/Carlos Osorio) ORG XMIT: MERed13ea4854232ab4cfade8b44a36a
A patient holds a vial of insulin during a news conference outside a Windor, Ont. pharmacy on July 28, 2019. (AP Photo/Carlos Osorio) ORG XMIT: MERed13ea4854232ab4cfade8b44a36a (The Minnesota Star Tribune)

The UCare health plan has become the second Minnesota insurer to add a new benefit for members with diabetes — a $25 monthly spending cap on out-of-pocket spending on insulin.

"As the health plan with the largest enrollment through MNsure, we felt a special responsibility to be part of a solution to this important public health issue," UCare CEO Mark Traynor said in a news release. MNsure is the public website where individuals and families can shop for insurance if they don't get it through an employer.

The announcement this week from Minneapolis-based UCare said its 2020 individual and family plan members who have diabetes are eligible to have monthly expenses capped at $25 for insulin covered under their plan's formulary. The insurer estimates that its Bronze Plan members will save $325 per month, on average, a spokesperson said.

The benefit comes along with a bevy of diabetes programs encouraging healthy lifestyles, including programs that offer compensation for purchasing healthy food, and discounts on gym memberships and education courses, the insurer said.

UCare said the $25 spending cap on insulin was made possible by an IRS regulation published last month. The new rules classify insulin as a "preventive care" product, which means that it can be offered through high-deductible plans without the member first needing to meet their minimum deductible for the year, the IRS said.

"UCare partnered with our pharmacy benefit manager and insulin manufacturers on a plan to bring down the monthly cost of insulin for members," the UCare announcement said. A spokeswoman noted that the $25 cap applies to all of UCare's individual and family plans on MNsure.

Last week, Minnetonka-based Medica announced a benefit for 2020 that caps monthly out-of-pocket spending on formulary insulin at $25 for people who buy Medica coverage through MNsure, and those who have fully insured Medica coverage through an employer based in the state.

Joe Carlson • 612-673-4779

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Joe Carlson

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Joe Carlson wrote about medical technology in Minnesota for the Star Tribune.

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