A pharmacist works to fill prescriptions.

Madonna McGuire Smith, of Corvallis, has a husband and three children, each with a chronic bleeding disorder and each needing expensive medication.

She and her husband struggled to cover their yearly health insurance out-of-pocket maximum of $7,500.

“Every year we would scrimp and save,” she said.

Things became easier for their family when pharmaceutical manufacturers began providing copay assistance, which helps reduce total out-of-pocket costs for patients who need expensive medications.

But for many, insurer programs called copay accumulator adjustment policies (CAAPs) add a further hurdle, not counting that manufacturer coupon amount toward the patient’s annual out-of-pocket maximum.

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