Are state laws requiring coverage of prescriptions enforceable?
My toddler has a food allergy and has a prescription for an EpiPen. We live in a state where a state law just went into effect to cap the cost of EpiPens at $60. When her EpiPen was over $60 I asked the pharmacy and they said that was controlled by insurance. I reached out to insurance and they said they don’t control that because it’s controlled by CVS Caremark’s prescription coverage. So I contacted them and they pointed back to our insurance. I tried them again and they pointed us back to the pharmacy, which means our insurance wasn’t even consistent on who to blame. I contacted our governor’s office and reached out to the senator that sponsored the bill, which led to the state department of insurance calling me. When I spoke to them, they told me that due to specific wording on the back of our insurance card, the employer controls the cost. When my husband reached out to his HR, they said insurance companies are getting out of adhering to those kind of laws by “not being domiciled” in our state. Are these type of laws actually being enforced? Does anyone have experience with getting insurance to comply?