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Health Insurance: Manufacturer Coupons Must Count Towards Patient Deductibles.

This law requires health insurance plans to count all forms of financial assistance, such as manufacturer coupons, discounts, or third-party payments, toward a patient's annual cost-sharing requirements (deductibles, copayments, and out-of-pocket limits). This change ensures that financial help received for medications directly reduces the total amount a patient must pay out-of-pocket each year. It aims to prevent insurers from using schemes that currently negate the value of patient assistance.
Key points
All financial assistance, including drug manufacturer coupons and third-party payments, must be applied toward the patient's annual deductible and out-of-pocket maximum.
This protects patients who rely on assistance programs for expensive treatments by ensuring that the aid genuinely lowers their yearly financial burden.
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Additional Information
HELP Copays Act
Print number: S 1375
Sponsor: Sen. Marshall, Roger [R-KS]
Process start date: 2023-04-27