No one fakes breast cancer for free chemotherapy.
So why do health plans charge patients a copay to prove they're sick?
More than half of U.S. women say they would skip breast cancer treatment if their out-of-pocket costs are over $2,000. No one should have to fight cancer and their insurance company.
#FixInsurance
Health plans shouldn’t charge out-of-pocket costs for prescribed medicines.
If you agree, join us.
Add your name to our list of patients, caregivers, and other Americans fed up with out-of-pocket costs.
Most of us pay for health insurance for many years while we’re healthy so that we can afford and access appropriate treatments when we get sick or injured.
Yet many insurance plans still charge high out-of-pocket costs not everyone can afford for prescription drugs and other vital treatments – even those specifically authorized by their plan.
In the case of novel, expensive medicines, high out-of-pocket costs unfairly burden the sick with incentivizing innovation even though those medicines will one day become generic and benefit all of us. We should pay for them together, out of the premiums we all pay.
In the case of medicines that already have gone generic, some plans (PBMs) still make patients pay high list prices, more than the drug actually costs the plan, claiming that the extra money patients are paying helps offset premiums for everyone. But the sick subsidizing the healthy is the opposite of insurance.
Let’s reform insurance so that we can pay for all of this innovation together – without high out-of-pocket costs. That’s how we fix the root of the affordability problem not just for today’s medicines but also tomorrow’s.
Our Solution
Cap out-of-pocket costs.
Cap out-of-pocket costs at $2,000 and smooth them over the year for all marketplace plans.
Prevent abuse of prior authorization.
Prior authorizations should be real-time, electronic, and frictionless, serving to confirm that a prescription is appropriate, not as many plans use them today as time-consuming obstacles to discourage doctors from prescribing even appropriate medicines.
Expand access to insurance.
Extend subsidies for individuals and families buying insurance through the Affordable Care Act.
RELATED RESOURCES
Demand first dollar coverage
for your medicines.
1 in 7 Americans has an autoimmune disease. But some insurance plans charge high out-of-pocket costs for prescribed medicines? Why? We paid our premiums. Don't make patients pay twice.
Why is there a copay
for cancer medicine?
You should never have to fight cancer and your insurance company. Half of cancer patients abandon treatment when out-of-pocket costs exceed $2,000. Prescribed treatments authorized by your insurer should have zero copays.
Why is there a copay
for insulin?
If you have Type 1 diabetes, you need insulin to live. But some health plans charge copays for insulin, so patients have “skin in the game." Let’s cap out-of-pocket costs for life-saving medicines like insulin.
Why is there a copay
for asthma inhalers?
Why does insurance charge people out-of-pocket for a medicine no one would take if they didn't have to? No one fakes asthma for free inhalers. We can eliminate out-of-pocket costs for prescribed medicines
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