MassHealth member rights and drug copay increases

As of February 1, 2009, the pharmacy copays for most generic MassHealth and Health Safety Net drugs increased from $1.00 to $2.00. Other regulations regarding member rights for pharmacy copays have not changed.

Copays for generic antihypertensives (which treat high blood pressure), antihyperlipidemics (which treat high cholesterol), and antihyperglycemics (which treat diabetes) will remain at $1.00.

Pharmacists are required by law to fill authorized prescriptions even if a MassHealth member cannot pay the copay at the time – and even if they owe old copay bills. However, pharmacies can still bill MassHealth members and members are still liable for unpaid copay bills.

• A flyer, February 2009 Increases to MassHealth Copays: Know Your Rights as a MassHealth Member (PDF), explains what has changed and what hasn’t.

Many thanks to Health Care For All and Health Law Advocates for originally creating and publishing the know-your-rights information included in this updated resource.

For official information, please see the MassHealth member notice (PDF) in English and Spanish.