Affordable Insulin Now Act

Reduced Out-of-Pocket Costs for Insulin: Group health plans and health insurance issuers would be prohibited from applying any deductible to selected insulin products, and cost-sharing would be capped at the lesser of $35 or 25 percent of the negotiated price per 30-day supply (Section 2, subsection a; Section 2, subsection b; Section 2, subsection c).

Benefit Toward Financial Thresholds: Any cost-sharing payments made for these insulin products will count toward a person's deductible or out-of-pocket maximum (Section 2, subsection a; Section 2, subsection b).

Coverage Under Catastrophic Plans: Health plans described in specific sections will provide coverage for selected insulin products even before an enrolled individual has met their annual limitation in cost-sharing expenses (Section 2, subsection e).

Limited Scope of Coverage: The rules regarding deductibles and cost-sharing caps only apply to "selected insulin products," which are products chosen by the group health plan or health insurance issuer (Section 2, subsection a; Section 2, subsection b).

No Protections for Out-of-Network Care: The bill does not require plans to provide these specific benefits for insulin products delivered by an out-of-network provider, nor does it prevent plans from charging higher cost-sharing amounts for out-of-network delivery (Section 2, subsection a; Section 2, subsection b).

Exclusion of Non-Selected Products: The requirements do not mandate coverage for, or prevent different cost-sharing structures for, insulin products that are not designated as "selected insulin products" (Section 2, subsection a; Section 2, subsection b).