If you:

  1. Have private health insurance, perhaps offered by your employer
  2. Have a high deductible plan
  3. Take a medication such as a biologic or other medicine to treat a chronic illness
  4. Use a manufacturer co-pay card toward your monthly prescription co-pay

Then you should be aware that your plan MAY HAVE implemented a key change, with a program called a “co-pay accumulator adjustment” or “co-pay adjuster”, that may impact your out-of-pocket finances.

We are doing our best to help everyone in our community impacted by an abrupt change in their insurance plan navigate a solution or relief. If you are experiencing a much higher co-pay requirement because your insurer didn’t count your manufacturer co-pay card toward your plan deductible, or if you’re not sure if your insurance plan has implemented the co-pay accumulator, follow these steps:

First, contact the manufacturer of your medicine. If you use a co-pay card from the manufacturer, contact them directly to alert the manufacturer about your specific financial situation. They may have additional resources or other ways to help you that they’ve instituted, in response to this new plan design. If you have trouble finding how to contact the manufacturer, click here https://creakyjoints.org/support/arthritis-copay-cards-assistance/

If you’d like more background on the subject, this is a helpful post: http://www.drugchannels.net/2018/01/copay-accumulators-costly-consequences.html

Then, contact your health insurance company. Inquire about whether there are changes to your ability to use a co-pay card. Take careful notes and document everything.

If you are no longer able to use a co-pay card, and you are financially impacted by this, contact your employer’s human resources benefits department. They’re the people who select these high-deductible plans that you selected, and they need to be aware of the changes that are being made to those plans (and its impact on their employees).

Finally, please join our effort to help fight this problem. We demand greater transparency and fairness by the health insurance companies. Consider getting involved. It’s easy. If you have received information pertaining to your plan changes (and the financial impact to you), consider first blanking out your personal details (name, address, ID) and then scanning a copay and sending to us. We’re looking closely at whether plans have provided sufficient notice to patients, and if there are other opportunities for recourse. Join our 50-State Network and share your story so that we can amplify your voice and demand action on behalf of all patients.

If you have questions or would like to talk more about this subject with us, please let us know.


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