12/7/2023 0 Comments Ajovy copay cardWithout knowing that the plan they have been in will no longer count copay coupons towards their out-of-pocket spending can translate into unexpected prescription drug costs that can equal several thousand dollars in a single month. This helps consumers make informed decisions while they are selecting a plan, ensuring it best suits their medical needs and is affordable. Health insurers must present their health benefit design and patient costs in a transparent manner. The AIDS Institute discovered just how difficult it is to find and decipher the relevant information. In response, patient advocates are ringing the alarm, warning against the harm these copay accumulator policies will cause to beneficiaries and how difficult it is to determine if the plan they are in is implementing this new practice.Ĭoncerned by the impact copay accumulators will have on people accessing HIV and hepatitis C drugs, The AIDS Institute, based in Tampa, Florida and Washington DC, examined Florida’s qualified health plans to determine if and how plans were implementing these new policies. (See Copay Accumulators: Costly Consequences of a New Cost-Shifting Pharmacy Benefit.) This new practice prevents manufacturer copay assistance from counting towards a beneficiary’s deductible and maximum out-of-pocket spending. In January, Drug Channels kicked off the year by examining a new health insurance benefit design that has gained traction among pharmacy benefit managers and health plans called copay accumulator adjustment programs.
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