11/20/2025

Oral Chemotherapy Copay and Coinsurance Cap Coming Jan. 1, 2026

Blue Cross Blue Shield of Michigan Announcement

Effective January 1, 2026, Blue Cross Blue Shield of Michigan and Blue Care Network will implement a cap on member cost-sharing for oral chemotherapy medications covered under the pharmacy benefit.

In accordance with Michigan Public Act 170 of 2023, the copay and coinsurance for self-administered antineoplastic medications will be limited to $250 per month for a 30-day supply, after the deductible has been met.

Each year, beginning January 1, the Michigan Department of Insurance and Financial Services may adjust this cap based on the prescription drug index of the medical care component of the U.S. consumer price index. This change applies to commercial members with individual coverage or coverage through a fully insured group.

Oral_Chemo_Cap_2026.pdf