Massachusetts H4492 establishes separate out-of-pocket limits for prescription drugs, including specialty drugs, in health insurance policies.
Massachusetts H4492 mandates that health insurance policies, contracts, and certificates delivered, issued, or renewed within the state establish a separate out-of-pocket limit for prescription drugs, including specialty drugs. This limit cannot exceed the minimum annual deductible for a high deductible health plan under federal law. The bill applies to all relevant health insurance policies delivered, issued, or renewed on or after January 1, 2026.
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