Insurance: health benefits; application of amount paid by the insured or other certain parties when calculating the insured’s co-pay for a prescription drug; require under certain conditions. Amends 1956 PA 218 (MCL 500.100 - 500.8302) by adding sec. 3406nn.
Key claim: Michigan HB6212 would require insurers to count amounts paid by the insured or certain third parties (such as drug manufacturer copay cards) toward the insured’s prescription drug co-pay calculation under specified conditions.
Abstract
(HB6212 · 103rd Legislature) Insurance: health benefits; application of amount paid by the insured or other certain parties when calculating the insured’s co-pay for a prescription drug; require under certain conditions. Amends 1956 PA 218 (MCL 500.100 - 500.8302) by adding sec. 3406nn. Latest action (2026-07-14): Bill Electronically Reproduced 07/03/2026
Why this matters
Copay accumulator and maximizer programs let insurers exclude manufacturer-provided copay assistance from a patient’s deductible and out-of-pocket calculations, shifting cost burden onto insureds who rely on such assistance for high-cost drugs. HB6212 would restrict that practice in Michigan’s private insurance market, affecting insurers, patients using copay cards, and drug manufacturers, and aligning Michigan with a growing set of states regulating these arrangements.