As part of its broader efforts to reign in health care prices that place a tremendous financial burden on families throughout the state, Blue Cross and Blue Shield of Minnesota (Blue Cross) plans to offer insulin coverage to thousands of members with a $0 co-pay at the point-of-sale (pharmacy counter).
Beginning on January 1, 2020, Blue Cross will include Tier 1 and Tier 2* insulin options as a covered benefit with no member cost-sharing in plans where Blue Cross sets the health plan benefits and manages the financial risk. (Collectively referred to as "fully insured" plans.) These include plans offered to Individuals and Families (both on and off MNsure); small employers; and most large employers.
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All eligible individuals and employer groups will have this benefit change go into effect on January 1, 2020, regardless of their plan renewal date. These proposed changes are subject to the review and approval of regulatory agencies with the State of Minnesota. Blue Cross did not adjust its filed premium rates for 2020 as a result of adding this benefit.
"Our first responsibility is to do what we can to improve the health and financial stability of our members," said Dr. Craig Samitt, president and CEO of Blue Cross and Blue Shield of Minnesota. "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."
"The problem is much larger than insulin," Samitt said. "More must be done to hold pharmaceutical companies accountable for the astronomical and arbitrary prices they set for medications that treat a range of serious and chronic issues. With no oversight or accountability, these companies will continue to charge whatever they want, with impunity. As a state, we need to work together and address the root causes of what is making affordable treatment out of reach for too many people."
The insulin benefit change at Blue Cross applies only to members in commercial fully insured plans. Many large employers and most national corporations set their own health benefits, which Blue Cross then administers with access to a Blue Cross provider network. These employers are referred to as being "self-insured." Blue Cross has the ability to administer a similar insulin benefit at the direction of these self-insured clients.