Additional Information:

Most North Carolina health insurers are now implementing “copay accumulator adjustment programs,” which prohibit copay assistance from any third-party, including a church, foundation, GoFundMe, or copay card, from counting toward a patient’s annual deductible or out-of-pocket maximum.

This means any third-party copay assistance will reduce a patient or family’s cost sharing burden, and means that copays are paid twice: once from copay assistance and again from the patient or family. It’s not fair and only pads the pockets of health insurers and PBMs.

We must include protections against copay accumulator adjustment programs in Senate Bill 257, which is currently being considered by the NC General Assembly.

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