Insurance Companies Will Have to Cover EpiPen for Kids Under New Illinois Law

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Illinois will become the first state in the nation to require that insurance companies cover the EpiPen auto-injector for anyone 18 years of age or younger. The state bill, which passed 92-0 in the Illinois House and 51-0 in the state Senate, will take effect on January 1, 2020.

The EpiPen is a life-saving medication that’s used in emergencies when people experience a severe allergic reaction. Between 8 and 12 percent of American kids have food allergies, depending on whose statistics you believe, and out-of-pocket medical costs in the U.S. can be extreme, even for families that have insurance. Some insurance plans already cover the EpiPen, owned by drug company Mylan, and the new generic auto-injector, produced by Teva, but now all insurance plans in Illinois will be required to cover them in some version.

“With steady increases in food allergies and other serious allergic conditions, families are relying on EpiPens more than ever before,” Illinois State Senator Julie Morrison said in a statement posted to her website. “We should be doing everything we can to expand access to affordable lifesaving drugs and medicines. No child with a serious allergy should be without an epinephrine injector because they cannot afford one.”


Just because insurance is now required to cover the drug, that doesn’t mean it will be free. One study published in the Journal of the American Medical Association in 2016 found that EpiPen users with insurance in the U.S. were spending about $75.50 every year on the drug, up from $33.80 in 2007. People in Illinois with health insurance will still have to pay for EpiPen, they just won’t be paying the list price, which currently sits at over $600.

The EpiPen made headlines back in the summer of 2016 when it was revealed that the company had jacked-up prices from about $57 for a single device in 2007 to over $600 for a two-pack. Mylan, the company responsible for the price gouging, had purchased the drug and simply raised the price because it didn’t have any competitors. The CEO of Mylan even testified to a House Oversight Committee in 2016, lying about how much the company made on each prescription. The CEO was never charged for lying to Congress.


“This legislation takes a big step forward in protecting our children and families,” Illinois Governor J.B. Pritzker told local news outlet WIFR. “Lowering the cost of prescription drugs and expanding health care coverage is one important way to help lower costs and build a higher standard of living for all Illinoisans.”