Ban Copay Accumulator Programs
I write to request your support for HB4353, which puts patients first by banning the use of copay accumulator programs implemented by health insurance companies.
Many patients are not able to afford medications prescribed by their doctors to manage chronic conditions like asthma and food allergies to maintain health. In order to make expensive medications more accessible, manufacturers sometimes provide co-pay coupons or copay assistance cards to help patients cover the cost.
In past years, the value of co-pay coupons has counted toward a patient’s annual deductible. However, insurance companies are increasingly refusing to count this third-party assistance toward patient out-of-pocket requirements. They have created new “co-pay accumulator adjustment programs” which allow patients to access and pay for high-cost prescription drugs but do not apply their value toward a patient’s deductible or out-of-pocket costs. This is particularly concerning when there is no generic alternative for medications, which is the case for most drugs used to treat chronic illnesses like asthma. In these cases, failing to count co-pay coupons toward a patient’s deductible leaves the patient with no affordable coverage option. Many must choose between the financial burden of covering these unexpected costs or not using their needed medications.
It is imperative that insurers count manufacturer co-pay coupons or assistance toward an enrollee’s annual deductible and that these companies are transparent about co-pay accumulator programs and patient’s annual out-of-pocket costs at the time of open enrollment, with information provided in language easily understood by all patients.
Thank you very much for your consideration, and I hope this legislation becomes law to protect and improve the lives of those with asthma, allergies and related conditions.
Please Ban Copay Accumulator Programs
I write today to request your support for HB4353, which puts patients first by banning the use of copay accumulator programs implemented by health insurance companies.
Many patients are not able to afford the medications prescribed by their doctors to manage chronic conditions like asthma and food allergies to maintain health. In order to make expensive medications more accessible, manufacturers sometimes provide co-pay coupons or copay assistance cards to help patients cover the cost.
In past years, the value of co-pay coupons has counted toward a patient’s annual deductible. However, insurance companies are increasingly refusing to count this third-party assistance toward patient out-of-pocket requirements. They have created new “co-pay accumulator adjustment programs” which allow patients to access and pay for high-cost prescription drugs but do not apply their value toward a patient’s deductible or out-of-pocket costs. This is particularly concerning when there is no generic alternative for medications, which is the case for most drugs used to treat chronic illnesses like asthma. In these cases, failing to count co-pay coupons toward a patient’s deductible leaves the patient with no affordable coverage option. Many must choose between the financial burden of covering these unexpected costs or not using their needed medications.
It is imperative that insurers count manufacturer co-pay coupons or assistance toward an enrollee’s annual deductible and that these companies are transparent about co-pay accumulator programs and patient’s annual out-of-pocket costs at the time of open enrollment, with information provided in language easily understood by all patients.
Thank you so much for your consideration, and I hope this legislation becomes law to protect and improve the lives of those with asthma, allergies and related conditions.