Co-pay accumulators or similar programs lead to greater out-of-pocket costs for individuals with life-threatening, chronic and rare diseases and should be prohibited.
Congress, the Centers for Medicare and Medicaid Services (CMS), and insurers should prohibit harmful co-pay accumulator programs and allow commercially-insured patients to use manufacturer co-pay cards and coupons to meet their deductibles.
Why co-pay accumulators should be prohibited
Deductibles, co-pays, and coinsurance have increased dramatically in recent years, and co-payment cards have become even more crucial for economically vulnerable patients. However, commercial insurance co-pay accumulator policies prevent patients from using co-pay cards and coupons to count toward their deductibles, resulting in a much larger overall out-of-pocket financial burden.
These policies are especially harmful to lower income patients who require expensive medications and those enrolled in high-deductible health plans.
For years, I was able to use co-pay cards from the drug manufacturers to pay for my medications. It was shocking to have a $10,000 surprise in January. It had taken us years to build our savings and then they were gone.– Robin Lancaster, living with primary myelofibrosis