Insurance must count your payments toward drug cost caps

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.

Introduced· 2026-04-22

Who's it for

Who's it for: Everyday People

What it means for you

8/10Helps you

Good for everyday people ·

Plain‑English summary, cross‑checked against the official bill text.

If passed, health plans would count any money you or someone else pays toward your drug copay or deductible, lowering what you owe later.

Our take

What we think, in plain words.

This bill helps people by making every dollar they spend count, so they hit their out‑of‑pocket limit faster and pay less for prescriptions. Insurers will have to adjust their accounting, but everyday folks could see lower bills.

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The facts

What the bill actually says, no spin.

The bill adds section 3406nn to Michigan's insurance code.
It applies to all health insurance policies sold after Dec 31, 2025.
Insurers must include enrollee payments when calculating out‑of‑pocket maximums and cost‑sharing.
The rule covers both high‑deductible and non‑high‑deductible plans.