This bill amends several chapters of the General Laws to establish a separate out-of-pocket limit for prescription drugs, including specialty drugs, in health insurance policies, contracts, and agreements issued or renewed within the Commonwealth. Specifically, it introduces new sections—47AAA in Chapter 175, 8EEE in Chapter 176A, 4EEE in Chapter 176B, and 4WW in Chapter 176G—that mandate these out-of-pocket limits. The limits cannot exceed the minimum annual deductible for high deductible health plans as defined in the federal Internal Revenue Code, and the term "out-of-pocket limit" encompasses certain cost-sharing expenditures related to prescription drug coverage.

The provisions outlined in the bill will take effect for all relevant policies, contracts, and certificates delivered, issued, or renewed on or after January 1, 2026. This legislative change aims to enhance financial protection for patients by ensuring that their out-of-pocket expenses for prescription drugs are capped, thereby promoting access to necessary medications.