Commonwealth of Massachusetts

Massachusetts $25 Insulin Cap

$25/30-day insulin cap on state-regulated commercial plans, automatic at the pharmacy. PACT Act 3.0 also provides $0 for selected generic diabetes drugs.

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.

Your estimated copay

$25per 30-day fill
Start application

Covered medications

  • Any insulin covered by your plan 30-day supply
  • Selected generic diabetes drugs (per PACT Act 3.0) $0 cost-share
Start application

No application required. Self-insured ERISA plans are exempt — those are federally regulated. Under PACT Act 3.0, MA state-regulated commercial plans also cover selected generic diabetes drugs at $0 cost-share — ask your pharmacist or insurer which generics qualify.

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