An Act relative to patient financial protection

This bill requires health insurance plans in Massachusetts covering prescription drugs to establish a separate out-of-pocket limit for those drugs - including specialty drugs - distinct from other medical costs. The limit cannot exceed the federal minimum annual deductible for high-deductible health plans (set under IRS code 26 U.S.C. §223), which covers both self-only and family coverage. It defines "out-of-pocket limit" to include cost-sharing expenses like copays under the Affordable Care Act. The rule applies to all relevant health insurance policies renewed or issued on or after January 1, 2026, directly affecting insurers and patients with prescription drug coverage.