Texas · Through 89th 2nd Called Legislative Session, 2025

Tex. Insurance Code § 1358.103: LIMIT ON COST-SHARING REQUIREMENT.

Where this section sits in the code

INSURANCE CODE
TITLE 8. HEALTH INSURANCE AND OTHER HEALTH COVERAGES
SUBTITLE E. BENEFITS PAYABLE UNDER HEALTH COVERAGES
CHAPTER 1358. DIABETES
SUBCHAPTER C. COST-SHARING LIMIT

(a) In this section, "insulin" means a prescription drug that contains insulin and is used to treat diabetes. The term does not include an insulin drug that is administered to a patient intravenously.

(b) A health benefit plan may not impose a cost-sharing provision for insulin that is included in the health benefit plan's formulary if the total amount the enrollee is required to pay exceeds $25 per prescription for a 30-day supply, regardless of the amount or type of insulin needed to fill the enrollee's prescription.

Added by Acts 2021, 87th Leg., R.S., Ch. 589 (S.B. 827), Sec. 1, eff. September 1, 2021.

Collected 2026-08-27T01:47:21Z. Source file · JSON

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