Health
insurance covering injected or intravenous chemotherapy and oral chemotherapy is prohibited from requiring a higher
copayment,
deductible, or
coinsurance amount for oral chemotherapy than they require for injected or intravenous chemotherapy. For high-deductible health plans, the limitation applies only after the
insured's deductible has been satisfied.
Health plans limiting copayments paid by covered individuals to no more than $100 for a 30-day supply of an oral chemotherapy medication are considered to comply with this mandate. Annually on January 1, health plans may adjust the $100 limit by an amount not exceeding the percentage increase in the U.S. consumer price index for all urban consumers, U.S. city average, as determined by the U.S. Department of Labor. [s. 632,867, Wis. Stat.]