Copay Accumulator Policies Discriminate

Copay Accumulator Policies Discriminate Against Patients with Chronic Illness

On February 1, 2022, The AIDS Institute released a new report showing that copay accumulator adjustment policies (CAAPs) are widespread across the individual insurance marketplace.

A CAAP prevents patients with chronic illness from including copay assistance in the patient’s annual deductible and out-of-pocket costs. Under this system, financial assistance that is intended to help patients pay for their specialty medications is instead benefitting the insurance company.

This research reaffirms that without federal regulation or state legislation, insurers will continue to apply these policies. Stephanie Hengst, Manager of Policy and Research at The AIDS Institute, said in a prepared statement, “People across the US are struggling to pay for basic necessities as a result of the on-going pandemic, and these policies that unfairly target already-vulnerable patients add a layer of financial stress. These policies will undoubtedly force many chronically ill patients to ration or forego their treatments.”

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