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“Description: Prescription drugs represent a small component of National Health Expenditures; however they are a common source of recurring high out-of-pocket payments by individuals. Health insurance and coverage for prescription medicines offers one of the most effective ways to support filling and continued use of medicines for prevention condition management treatment and cure where possible. The lack of insurance is a well-documented cause of failure to fill prescriptions refill them and/or take less than the prescribed amount. Now having insurance may not be a buffer to high out-of-pocket payments placing medicine beyond the reach of those who may need it the most. This presentation and discussion will examine principles for ethical design of benefits and how current practices do or do not reflect those principles.”