Copay Accumulator Usage Is on the Rise

At least two-thirds of health insurance plans offered in the Affordable Care Act marketplaces in 32 states include a copay accumulator adjustment policy (CAAP), which prevents drug manufacturer coupons from counting toward patients’ annual deductibles or out-of-pocket cost limits, according to a recent study by The AIDS Institute. Meanwhile, the Business Group on Health’s 2021 Large Employers’ Health Care Strategy and Plan Design Survey showed that large companies are increasingly adopting copay accumulator programs to reduce prescription drug costs, as 49% of employers said they either had such a program in place in 2020 or were adding one in 2021, and another 14% planned one for 2022-2023.

SOURCES: “Double-Dipping: Insurance Companies Profit at Patients’ Expense,” The AIDS Institute, March 2021. Visit https://bit.ly/3rgN3Td. “2021 Large Employers’ Health Care Strategy and Plan Design Survey,” Business Group on Health, August 2020. Visit https://bit.ly/3f8L692.

© 2024 MMIT
Jinghong Chen

Jinghong Chen Reporter

Jinghong has been producing infographics and data stories on employer-sponsored insurance, public health insurance programs and prescription drug coverage for AIS Health’s Health Plan Weekly and Radar on Drug Benefits since 2018. She also manages AIS Health’s annual executive compensation database for top insurers and Blue Cross and Blue Shield affiliates. Before joining AIS Health, she interned at WBEZ, Al Jazeera English and The New York Times Chinese. She graduated from Missouri School of Journalism with a focus on data journalism and international reporting.

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