Right now, some insurers use “copay accumulator” policies that create hidden barriers to care.
Copay accumulators are insurance policies that prevent financial assistance from counting toward a patient’s deductible or out-of-pocket maximum.
Here’s how it works:
Many patients with serious or rare conditions rely on copay assistance — often from manufacturers or foundations, to afford their medications. Normally, when a payment is made, it helps the patient move closer to meeting their deductible or yearly out-of-pocket limit.
But with a copay accumulator in place, the insurance company still accepts the payment and gets paid, it just doesn’t credit it toward the patient’s deductible or out-of-pocket maximum.
When that assistance runs out, families can suddenly owe thousands of dollars, even though payments were already made earlier in the year.
For people living with bleeding disorders, treatment is life-sustaining and non-negotiable. These unexpected costs can disrupt access to care and create serious financial strain.
The bipartisan HELP Copays Act would require all payments made on behalf of a patient to count toward their cost-sharing limits, close loopholes insurers use to avoid this responsibility, and help create clear, reliable pathways to care.
Take action today.
Ask your Members of Congress to cosponsor the HELP Copays Act and ensure copay assistance counts toward patient costs. When we speak up together, we protect access to life-sustaining treatment and keep care within reach for our community.