S5, Ep 6- Copay Accumulators Explained: Why Advocacy Matters

The impact of copay accumulator policies can create additional financial difficulties for patients by limiting payments that count toward their annual deductibles and out-of-pocket maximums. As a result, millions of patients who are already struggling with the financial and physical toll of their condition may delay care or stop taking their medication altogether leading to worsening health.

“Copay accumulator adjusters are a program used by insurance companies to force patients to take medications that they determine are cheaper for them. And, in reality, it's actually just cheaper for the insurance company,” says Corey Greenblatt, Senior Manager of Policy and Advocacy at GHLF.

Our guests, JP Summers, Patient Advocate and Community Outreach Manager at GHLF, and Corey, tell us more about their advocacy efforts and about their support for the bipartisan bill called the HELP Copays Act.

Among the highlights in this episode:

1:24: Listener comment

1:56: H.4929, a step therapy protection law, was passed by both the Massachusetts House and Senate in October after being introduced for the first time over five years ago

2:37: “Governor Baker has 10 days to sign this bill; otherwise, it will die and it would need to be repassed next year,” says Zoe Rothblatt, Associate Director of Community Outreach at GHLF

2:50: Results from a recent GHLF COVID-19 Patient Support Program quick poll shows that most respondents will be celebrating the holidays in person with only 5 percent canceling plans or celebrating virtually

3:30: Steven Newmark, Director of Policy at GHLF, gives some tips to stay safe this holiday season

5:42: JP Summers describes her – and Corey Greenblatt’s – participation to the virtual advocacy event: All Copays Count Coalition Hill Day

6:54: What are copay accumulators?

8:47: The HELP Copays Act explained

9:27: A look back at JP Summers’ chronic illness journey and how the HELP Copays Act could impact her and other patients if passed

11:35: Are there bills similar to the HELP Copays Act at the state level?

12:18: How patients can get involved and advocate for themselves

12:59: What goes through an advocate’s mind when meeting with elected officials?

15:38: What our hosts learned from this episode

Contact Our Hosts

Steven Newmark, Director of Policy at GHLF: [email protected]

Zoe Rothblatt, Associate Director, Community Outreach at GHLF: [email protected]

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