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Additional Resources

Use the following resources to educate your legislator about copay accumulator adjustment programs.

Click the button below to locate the state legislators who represent you.

Terms & Definitions

Copay Assistance

Is financial assistance typically provided by charitable organizations or drug manufacturers to help patients pay out-of-pocket costs for their medications or health care services

Coinsurance

The out-of-pocket costs a patient owes for a service or medication, calculated as a percentage of the total cost  

Copay Accumulator Adjustment Programs 

Exclude copay assistance payments from counting toward a patient’s annual deductible or out-of-pocket maximum. These programs undermine access to life-saving prescription drugs, making it more difficult for people living with chronic illnesses to adhere to a treatment plan

Deductible

The dollar amount the insured must pay per plan year before insurance coverage begins 

Out-of-Pocket (OOP) Maximum

The maximum dollar amount the insured is obligated to pay for services/treatments during the plan year, after which insurance will cover 100 percent of the costs

Policy Solution

Lawmakers can help patients afford critical treatments by ensuring all payments – made by or on behalf of patients – are counted toward the patients’ deductibles and out-of-pocket maximums

Copay Accumulator Adjustment Programs & the UACCC

Common Misconceptions:
12 states have protected patients by passing legislation to ensure all copays count:
Use.2022 State Map.001.jpeg

Video from the National Hemophilia Foundation:

Video from the AIDS Institute:

Podcast From the National Psoriasis Foundation: 

 Video From National Hemophilia Foundation CCSC:

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