ExchangeCoverageMedium impact
CareFirst to Implement DC Insulin and Diabetes Device Affordability Amendment Act
CareFirst BlueCross BlueShield·DC · Endocrinology, Family Medicine, Internal Medicine +1 more·Provider News
Effective date
Jan 1, 2022
We identified it
Jun 20, 2026
Summary
CareFirst will implement DC's insulin affordability law starting January 1, 2022, reducing cost-sharing caps for insulin from $50 to $30 per month and capping diabetes devices at $100. This applies to DC Individual/Small Group ACA plans, fully insured DC business, and DC grandfathered plans.
Action Required
By January 1, 2022: Billing team must verify patient eligibility for reduced diabetes cost-sharing in CareFirst Direct system before processing claims. Update billing software to apply new caps: $30 for non-preferred insulin and $100 for diabetes devices for eligible DC CareFirst members. Train staff to check patient benefits to confirm mandate applicability since not all CareFirst plans are covered.