Most health plans do not allow rebates and outside financial assistance to count towards a policyholder’s drug deductible, which critics assert penalizes enrollees.
The model measure introduced by the National Council of Insurance Legislators (NCOIL), a bi-partisan organization of state elected officials who specialize in insurance law, would require them to count those outlays towards coinsurance and deductibles.
It’s expected that some NCOIL members will introduce similar legislation in their home states in 2022 or in subsequent years.
If successful, such laws could be a boon for some patients who receive help from drug companies or whose drugs are eligible for rebates
This is a significant move as pharmaceuticals become more expensive and lawmakers and policymakers wrestle with how to make them more affordable and stem steep annual cost increases. Draft Would Help Policyholders Meet Drug Deductibles, Copays