Pennsylvania families — especially those managing chronic, complex, or rare conditions — depend on consistent access to their prescriptions to stay healthy and lead full lives. But rising costs at the pharmacy counter, harmful insurance practices, and mounting financial barriers are making it harder than ever to access care.
Pennsylvania families are counting on you.
Copay assistance programs are a lifeline for countless Pennsylvania families who couldn't otherwise afford their treatments. However, health insurers are undermining that benefit with predatory copay accumulator programs, which prevent any payments made with copay assistance from counting toward a patient's annual deductible or out-of-pocket maximum. As a result, patients can face thousands of dollars in unexpected costs, with no warning and nowhere to turn for help.
Insurance companies shouldn't get to double dip — collecting full deductible payments from patients on top of their copay assistance – while Pennsylvanians continue to struggle to pay for their care and support their families.
Send a message to your lawmakers today and urge them to address healthcare affordability challenges!
As your constituent, I urge you to support Senate Bill 268 (SB 268) and House Bill 2226 (HB 2226), the Prescription Drug Copay Fairness Act, and lower out-of-pocket costs for Pennsylvania families by banning copay accumulator programs.
For Pennsylvanians living with chronic or complex conditions, copay assistance isn't a convenience — it's often the only thing keeping the treatments they rely on within reach. However, predatory practices known as copay accumulator programs, which block any financial copay assistance from counting toward a patient's annual deductible or out-of-pocket maximums, are driving up out-of-pocket costs for patients
Copay accumulators are increasingly hidden in insurance policies, and often cause patients to be blindsided mid-year by unanticipated healthcare costs when they learn they must continue to pay toward their cost-sharing requirements for their insurance to kick in.
For most patients, switching to a cheaper alternative simply isn't an option. More than 99% of copay assistance is used for conditions that have no generic equivalent. These are not optional medications. For many Pennsylvanians, there is simply no substitute.
Insurance companies shouldn't get to double dip, pocketing and profiting from copay assistance while patients are left on the hook for their full deductible or out-of-pocket maximum. Ensuring all third-party assistance counts toward a patient's cost-sharing obligations is a commonsense solution.
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Thank you,
