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Illinois Passes New Law to Cap Costs of Epinephrine Injectors for Minors

In a significant legislative move, Illinois has enacted a new law aimed at making life-saving epinephrine injectors more affordable for families. Public Act 103-0454, which amends the Illinois Insurance Code, introduces a price cap on epinephrine injectors for individuals under 18 years of age, ensuring that no family pays more than $60 for a twin-pack of the injectors.

The law, set to take effect on January 1, 2025, mandates that both group and individual health insurance policies, as well as managed care plans that are issued or renewed from that date, must include coverage for medically necessary epinephrine injectors. This update builds on the existing provisions of Public Act 101-281 and aims to further relieve the financial burden on families needing these essential medical devices.

Under the new legislation, the term “epinephrine injector” is defined according to the Epinephrine Injector Act, ensuring clarity regarding the devices covered under this law. Importantly, insurers are also permitted to reduce the cost-sharing amount even more significantly than the law stipulates, potentially lowering costs further for insured parties.

Moreover, subsection (d) of the new amendment empowers the Department to adopt necessary rules for implementing and administering the updated law. This proactive measure is expected to streamline the enforcement and ensure that the benefits are efficiently passed on to consumers.

The enactment of this law is a response to the increasing cost of epinephrine injectors in recent years, which has placed a significant financial strain on many families across Illinois. By capping the cost at $60, the state legislature aims to ensure that no child is left vulnerable due to financial barriers.

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