Make All Copays Count — Tell Congress to end copay accumulator programs! 

Some health plans use copay accumulator programs that prevent financial assistance from counting toward your deductible or out-of-pocket maximum. When the assistance runs out, patients can face sudden, unaffordable pharmacy bills. 

For people with serious and chronic conditions, copay help from manufacturers, nonprofits like PAN, or family members is often the only way to stay on treatment. But accumulators allow insurers and pharmacy benefit managers (PBMs) to take these payments without applying them to your cost-sharing, leaving patients with much higher costs. 

The Help Ensure Lower Patient (HELP) Copays Act (H.R. 6423)/S. would fix this by: 

• Requiring all payments made by or for a patient—including copay assistance—to count toward deductibles and out-of-pocket limits. 
• Closing loopholes that let plans call medications “non-essential” to avoid counting cost-sharing. 
   

While many states have taken action to ban these programs, federal protections are urgently needed—especially for people in large-group and self-funded plans.