$35/30-day collective cap on state-regulated commercial plans, automatic at the pharmacy.
Application requiredCommercial insurance only
What you need to enroll
Application required
Fill out an application — income or residency documents may be needed. Approval typically takes 1–2 weeks. You'll need an active prescription to use the program once you're approved.
Yes — written by a licensed prescriber for the medications below.
Insurance required?
Commercial insurance only. Medicare, Medicaid, TRICARE, and VA are not eligible.
State restrictions?
Only available in IL.
Income limits?
No income test.
Accepted
Illinois residents on a state-regulated commercial plan
Auto-applied — no application required
Not accepted
Out-of-state residents
Self-funded ERISA employer plans
Medicare Part D, Medicaid, federal plans
How to apply
Present your insurance card at the pharmacy — the $35 cap is auto-applied if your plan is state-regulated
If billed more than $35, ask your insurer whether your plan is state-regulated or a self-insured ERISA plan
If denied on a state-regulated plan, file a complaint with the Illinois Department of Insurance
Medicare patients: use the federal $35/month insulin cap
Using it at the pharmacy
No card needed — the cap applies automatically. If billed more than $35 for a 30-day insulin fill, ask the pharmacist to apply the Illinois state insulin cap.