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 prevent 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.

Jinghong Chen Reporter

Jinghong produces infographics and data stories on health insurance and specialty pharmacy for AIS Health. She graduated from Missouri School of Journalism with a focus on data journalism and international reporting. Before joining AIS in 2018, she worked at WBEZ, Al Jazeera English and The New York Times Chinese.

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