#COPAY ACCUMULATOR HOW TO#
Researchers from the AIDS Institute looked at hundreds of plans across the country and developed a tip sheet to help guide searches. A dozen states have banned copay accumulators, and more are considering doing so.įor tips on how to avoid overpaying for drugs - when that’s possible - check out the latest edition of our First Aid Kit newsletter. Still, she recently got socked with an unexpected $3,000 charge - and expects to lose her very organized fight against it.įinding out whether an insurance plan includes one of these policies can be extremely tough. It’s confusing, but Karabaic was well aware of how it works. But if the drug company helps you with that $2,000 - sometimes they call it a “coupon” - it can charge your insurer $8,000 a month. Copay accumulators say these coupons can’t count toward an insurance plan’s out-of-pocket maximum. For instance, if a drug’s monthly cost is $10,000, few people with a 20% copay could afford $2,000 a month. In short, it’s an invention by the insurance industry to make sure only your money counts toward your yearly deductible - not any assistance you might receive from a drug company.ĭrug companies offer copay assistance to patients whose plans make them pay a percentage of a medicine’s price so that they charge insurers more. “An Arm and a Leg” is a podcast about these issues, and is co-produced by KFF Health News. But you’re not alone with this stuff, and knowledge is power. Health care - and how much it costs - is scary.
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