Establishes separate out-of-pocket limits for prescription drugs in Massachusetts health insurance plans.
This bill amends Massachusetts law to require health insurance plans to set separate out-of-pocket limits for prescription drugs, including specialty drugs. The limit cannot exceed the minimum annual deductible for a high deductible health plan under federal law. This applies to individual and group health maintenance organizations, medical service agreements, and hospital service plans. The bill also clarifies that the term "out-of-pocket limit" includes certain prescription drug cost-sharing expenditures.
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- Overview
- Core Provisions
- Implementation
- Impact
- Legal Framework
- Critical Issues
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