Bill > H1133

This bill requires all health insurance providers in Massachusetts to establish a separate out-of-pocket limit specifically for prescription drugs, including specialty drugs, which cannot exceed the annual deductible limit for high-deductible health plans as defined by the Internal Revenue Code. The bill applies to various types of health insurance plans, including insurance policies, hospital service plans, medical service agreements, and health maintenance organizations (HMOs). The out-of-pocket limit will include cost-sharing expenses as defined by the federal Patient Protection and Affordable Care Act, and will cover both self-only and family coverage. The provisions will take effect for all health insurance policies delivered, issued, or renewed on or after January 1, 2025, aiming to provide financial protection for patients by capping their annual expenses for prescription medications. By creating a distinct out-of-pocket limit for prescription drugs, the bill seeks to make healthcare more affordable and prevent patients from facing excessive drug costs.

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https://malegislature.gov/Bills/194/H1133