Several states have enacted legislation to limit out-of-pocket (OOP) costs for epinephrine. These laws primarily target state-regulated health insurance plans.
The following table summarizes the states that currently cap these costs, the cap amounts, whether the language specifically limits coverage to auto-injectors or broader administration methods such as nasal sprays, and the source of information.
State Epinephrine Cost Caps (As of 1/1/2026)
| State | Cap Amount | Coverage Scope | Source |
| New York | $100 per year | Broad: Includes auto-injectors and nasal sprays. | NY A.5392-B / S.7807-A |
| New Hampshire | Full Coverage ($0) | Broad: Law updated in 2025 to include all delivery systems. | NH HB 677 (2025) |
| Illinois | $60 per 2-pack | Broad: Co-pay limit applies “regardless of the type of epinephrine injector.” | IL Public Act 103-0454 |
| New Jersey | $25 per 30-day supply | Restrictive: Specifically “epinephrine auto-injector devices.” | NJ P.L. 2023, c.105 |
| Colorado | $60 per 2-pack | Restrictive: Specifically “epinephrine auto-injector.” | CO HB23-1002 |
| Minnesota | $25 per 30-day supply | Restrictive: Specifically “epinephrine auto-injectors.” | MN Statutes § 62Q.481 |
| Rhode Island | Full Coverage ($0) | Restrictive: For at least one “auto-injector and cartridge.” | RI Gen. Laws § 27-18-94 |
Clarification:
Restricted States (NJ, CO, MN, RI): In these states, the current statutory language remains tied to “auto-injectors.” Unless these states follow the NH and NY model of amending the text, patients may still face high costs for nasal sprays even though injectors are capped.
Key Legislative Nuances
- High-Deductible Health Plans (HDHPs): In states like New York and New Jersey, the cap may only apply after the deductible is met for certain HSA-qualified plans to avoid violating IRS regulations, though recent amendments in NY have attempted to clarify this for “preventive care” status.
- “State-Regulated” Limitation: These caps typically only apply to plans regulated by the state (e.g., individual marketplace plans and small-group employer plans). They generally do not apply to large employer “self-insured” plans, which are governed by federal ERISA law.
