$35/30-day cap on state-regulated commercial plans (eff. 1/1/2025), automatic at the pharmacy. Also covers diabetes equipment and supplies.
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.
Diabetes equipment and supplies covered by your plan30-day supply
Am I eligible?
Need a prescription?
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 NJ.
Income limits?
No income test.
Accepted
New Jersey 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 (insulin is also exempt from deductibles)
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 NJ Department of Banking and Insurance
Low-income seniors / disabled NJ residents: apply to NJSave (PAAD + Senior Gold) — call 1-800-792-9745 or apply through the NJ Department of Human Services
Using it at the pharmacy
No card needed — the cap applies automatically. New Jersey state-regulated plans top out at $35 per 30-day insulin fill.
No application required for the cap itself. Self-insured ERISA plans are exempt — those are federally regulated. NJSave is a separate state program for low-income seniors and people with disabilities.
Be first when we launch — we'll save these matches and remind you to renew.