Make Every
Copay Count
Patients should not be punished for getting help affording their medications.
Health plans and pharmacy benefit managers use copay accumulator policies to stop financial assistance from counting toward deductibles and out-of-pocket limits. Count My Copay exists to expose this practice and push for fair rules that protect patients.
A Hidden Policy with Real Consequences
Many patients rely on copay assistance from nonprofits or drug manufacturers to afford life-saving medications. But some insurers and PBMs refuse to count that assistance toward a patient’s deductible or out-of-pocket maximum.
Even though the payment is made, patients are treated as if it never happened.
Months into the plan year, patients suddenly face thousands of dollars in unexpected costs. Many are forced to delay or abandon treatment altogether.
WhO IS IMPACTED?
• People with cancer, autoimmune disease, multiple sclerosis, hemophilia, HIV, and other chronic conditions
• Patients enrolled in high-deductible health plans
• Families already stretched by rising premiums and drug prices
• Patients who did everything right and followed their insurer’s rules
For many, copay assistance is not a luxury. It is the difference between staying on treatment or going without care.
WHY IT MATTERS?
When patients cannot afford their medications, adherence drops, health declines, and costs rise across the system. Copay accumulator policies undermine coverage for pre-existing conditions and shift financial risk onto the people least able to carry it.
This is not a market solution. It is a loophole.
Patients shouldn’t have to read the fine print to stay alive.
Fill out the form below and contact your Missouri legislators today to let them know you stand with Missouri’s most vulnerable patients, not insurance company bottom lines.
DID YOU KNOW?
• Insurance companies often refuse to count copay assistance from private companies and charitable organizations toward deductibles and out-of-pocket limits, even though they accept and keep that money. Patients are then charged again.
• Copay accumulator programs allow insurers to double-dip, using assistance dollars to boost their bottom line while leaving the most vulnerable patients with higher bills and interrupted treatment.
• Insurance companies claim these protections drive patients to expensive brand-name drugs, but most copay protection laws apply only when no generic alternative exists.
• Twenty-four states, Washington, DC, and Puerto Rico have already limited or banned copay accumulator programs across red and blue states alike, because patient access to medication is not a partisan issue.
• A 2024 study found that banning copay accumulator programs reduced patients’ monthly out-of-pocket costs by $128 to $520 and made patients 14 percent more likely to stay on their medications, improving health and reducing hospitalizations.
Let’s put an end to this predatory and unfair practice and pass legislation in Missouri to make ALL COPAYS COUNT!
The following bills have this important patient assistance language included:
HB 1681 (Seitz), HB 1941 (Hruza), HB 2279 (Cook), SB 1327 (Nicola), SB 1448 (Schroer), SB 840 (Bernskoetter), SB 970 (Fitzwater)
Copyright 2026. Count My Copay is a patient-focused advocacy campaign dedicated to ensuring that co-payments made by or on behalf of patients count toward deductibles and out-of-pocket limits. Content is provided for informational and advocacy purposes only and does not constitute legal or medical advice.