Sec. 202. No patient cost-sharing
201 words·~1 min read·
/bill/119/s/1506/is/section-202·A research copy — for the controlling text, always check the official state or federal source. Not legal advice.
The Secretary shall ensure that no cost-sharing, including deductibles, coinsurance, copayments, or similar charges, be imposed on an individual for any benefits provided under the Medicare for All Program, except as described in subsection (b). The Secretary may set a cost-sharing schedule for prescription drugs covered under the Medicare for All Program— provided that— such schedule is evidence-based, patient-centered, and encourages the use of generic drugs; such cost-sharing does not apply to preventive drugs; such cost-sharing does not exceed $200 annually per individual, adjusted annually for inflation; and such cost-sharing is not imposed on individuals with a household income equal to or below 250 percent of the poverty line for a family of the size involved; and under which the Secretary may— exempt brand-name drugs from consideration in determining whether an individual has reached any out-of-pocket limit if a safe and appropriate generic version of such drug is available to such individual; and waive cost-sharing in response to a coverage appeal under section 203(b)(2).
Notwithstanding contracts in accordance with section 303, no provider may impose a charge to an individual enrolled for benefits under the Medicare for All Program for items and services for which benefits are provided under such Program.