A number of states have enacted laws to restrict out-of-pocket (OOP) prices for epinephrine. These legal guidelines primarily goal state-regulated medical health insurance plans.
The next desk summarizes the states that at present cap these prices, the cap quantities, whether or not the language particularly limits protection to auto-injectors or broader administration strategies reminiscent of nasal sprays, and the supply of data.
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State Epinephrine Value Caps (As of 1/1/2026)
| State | Cap Quantity | Protection Scope | Supply |
| New York | $100 per yr | Broad: Consists of auto-injectors and nasal sprays. | NY A.5392-B / S.7807-A |
| New Hampshire | Full Protection ($0) | Broad: Regulation up to date in 2025 to incorporate all supply programs. | NH HB 677 (2025) |
| Illinois | $60 per 2-pack | Broad: Co-pay restrict applies “no matter the kind of epinephrine injector.” | IL Public Act 103-0454 |
| New Jersey | $25 per 30-day provide | Restrictive: Particularly “epinephrine auto-injector gadgets.” | NJ P.L. 2023, c.105 |
| Colorado | $60 per 2-pack | Restrictive: Particularly “epinephrine auto-injector.” | CO HB23-1002 |
| Minnesota | $25 per 30-day provide | Restrictive: Particularly “epinephrine auto-injectors.” | MN Statutes § 62Q.481 |
| Rhode Island | Full Protection ($0) | Restrictive: For not less than one “auto-injector and cartridge.” | RI Gen. Legal guidelines § 27-18-94 |
Clarification:
Restricted States (NJ, CO, MN, RI): In these states, the present statutory language stays tied to “auto-injectors.” Except these states comply with the NH and NY mannequin of amending the textual content, sufferers should still face excessive prices for nasal sprays though injectors are capped.
Key Legislative Nuances
- Excessive-Deductible Well being Plans (HDHPs): In states like New York and New Jersey, the cap might solely apply after the deductible is met for sure HSA-qualified plans to keep away from violating IRS laws, although latest amendments in NY have tried to make clear this for “preventive care” standing.
- “State-Regulated” Limitation: These caps usually solely apply to plans regulated by the state (e.g., particular person market plans and small-group employer plans). They often don’t apply to massive employer “self-insured” plans, that are ruled by federal ERISA regulation.
