Copay Accumulator Calculator
About 39% of commercial health plans use copay accumulators — programs that do not count manufacturer copay card payments toward your deductible or out-of-pocket maximum. When the copay card cap is exhausted, you suddenly owe the full retail price.
Enter your drug details below to see exactly when your card runs out and what to do about it.
Copay Accumulator Calculator
Find out when your copay card will run out and what it will cost you.
The list price your insurance is billed, not what you pay. Check your EOB or ask your pharmacy.
The maximum annual benefit on your copay card. Check the card terms or the drug manufacturer website.
How copay accumulators work
When you use a manufacturer copay card, the drug maker pays most of the cost and you pay a small copay (often $0-$30). In a normal plan, the full amount billed counts toward your deductible — so the manufacturer is essentially helping you reach your deductible faster.
With a copay accumulator, only the amount youpay out of pocket counts. The manufacturer's payment is “accumulated” separately and does not reduce your deductible. Once the copay card cap is exhausted, you are still far from meeting your deductible, and you owe the full cost.
The result: a cost cliff. You pay $10/month for months, then suddenly owe hundreds per month when the card runs out.
Common drugs affected
Eliquis
Retail: $620/mo | Card cap: $6,400/yr | Copay: $10
Ozempic
Retail: $935/mo | Card cap: $150/mo savings | Copay: $25
Humira
Retail: $5,800/mo | Card cap: $6,000/yr | Copay: $5
Dupixent
Retail: $3,600/mo | Card cap: $13,000/yr | Copay: $0
States that have banned copay accumulators
As of 2026, 22 states plus Puerto Rico have banned copay accumulator programs for state-regulated (fully insured) plans:
AZ, AR, CO, CT, DE, GA, IL, KY, LA, ME, NJ, NM, NY, NC, OK, OR, TN, TX, VT, VA, WA, WV, PR
Important caveat: About 60% of employer-sponsored plans are self-funded (ERISA) and are notsubject to state insurance laws. Ask your HR department: “Is our health plan fully insured or self-funded?”