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1 bill on this topic
“Health plans should count help from charities, drug makers, or other outside sources toward a patient's deductible, copay, coinsurance, and out-of-pocket limit for covered prescription drugs, including specialty drugs and drugs that need prior authorization or step therapy once the plan covers them.”
1 bill on this topic
“Out-of-pocket cost limits should protect covered prescription drugs that fall within the prescription drug benefit category, without requiring health plans to cover every prescription drug.”
1 bill on this topic
“High-deductible health plans linked to Health Savings Accounts should be able to count charity or drug maker help for outpatient prescription drugs toward the deductible without losing their tax-favored status.”
1 bill on this topic
“Starting in 2027, Medicare Part D patients should not be charged more for a month of a covered drug than the lower of the plan's net price or the pharmacy's usual cash price for someone without insurance.”
1 bill on this topic
“For selected high-rebate Medicare Part D drugs, patients should pay coinsurance based on estimated prices after manufacturer rebates, while plans report rebate data and checks measure whether the estimates are accurate.”
1 bill on this topic
“Patients should be able to get selected insulin without meeting a deductible, pay no more than the lower of $35 or 25 percent of the plan's net negotiated price for a 30-day supply, and have those payments count toward yearly cost limits.”
1 bill on this topic
“Participating private health plans should not base a patient's copay or coinsurance for a selected drug on a price higher than the negotiated price, and should not charge cost sharing above that price.”
1 bill on this topic
“Private health plans should have to cover selected insulin products, including at least one option in each main insulin type and form, while plans choose which products get the capped terms and other insulin may cost more.”
1 bill on this topic
“Uninsured people should be able to get a 30-day supply of insulin for no more than $35 when they use a participating pharmacy or provider, with the federal government paying the rest and participating providers barred from charging more than the program allows.”
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