#Copay accumulator full
Previously, the full 500 copay would be credited to the individuals out-of-pocket spending and. Thanks to a coupon from the drugs manufacturer, the individual only pays 25 to fill a prescription and the coupon covers the other 475. In a web posting titled “Copay Accumulator Programs Level the Out-of-Pocket Playing Field,” Express Scripts refers to its “Out of Pocket Protection Program” as a way “to ensure an equal benefit for all members.” It reads, “Plan sponsors believe it is not fair to allow one member to utilize outside funding to satisfy their deductible while another has to meet it entirely with their own money.” That’s like complaining that one person has a wealthy aunt who contributes to their care and another doesn’t, pitting plan members against one another like a hunger games. Copay accumulator example: an individual has a copay of 500 for a specialty drug and a deductible of 1000. SaveOnSP describes itself as a “cost-saving healthcare solution” that focuses on “helping plan sponsors and their participants manage the skyrocketing costs of specialty pharmaceutical drugs.” At the same time, PBMs are pushing back on growing concerns. Making matters more opaque, companies don’t refer to themselves as accumulators or maximizers. What is a copay accumulator adjuster program These health insurance programs affect people who use drug copay cards (cards usually given by a drug manufacturer to help reduce the cost of taking the medication) by not counting the payment that these cards assist with toward the deductible set by the insurance company.
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