8/28/2023 0 Comments Accumulator healthcare![]() ![]() We are also calling on insurance commissioners and state attorneys general to investigate the impact that copay accumulator programs have in limiting access to life-saving medications for HIV & AIDS and other chronic conditions.įor more information on HRC’s work to end HIV and HIV-related stigma, click here. AIDS Foundation of Chicago has also released a blog and video that contains useful information for patients and consumers.Īs one of the first national LGBTQ organizations to endorse PrEP, HRC stands with our community partners in urging insurance and pharmaceutical companies to work together to ensure that everyone who seeks PrEP has access to this life-saving resource, regardless of their ability to pay. Lives are literally at stake.”Īccording to the AIDS Foundation of Chicago, BlueCross BlueShield, Cigna, United Healthcare, CVS Caremark and Express Scripts are currently implementing copay accumulator programs. Here’s how accumulator adjustment works: Say your pharmacy deductible is 500, which is typical here in California for a Bronze insurance plan. “And it can only be achieved by removing the obstacles that stand in the way of public health, not by setting up new barriers to effective prevention and treatment strategies. What are Copay Maximizers and Accumulators By ACMA, AugA recent article in the American Journal of Managed Care shed light on copay maximizer strategies among generics manufacturers. “We now have the tools and resources in place to end the HIV epidemic in the United States,” says Jay Brown, HRC Foundation’s Deputy Director of Programs, Research and Training. At $1,300 per month, the cost of PrEP without insurance makes it inaccessible for many individuals who would benefit from its use. These drugs often have copay assistance programs in place to help offset costs to patients. This policy will prevent many individuals from accessing and adhering to PrEP, also known as pre-exposure prophylaxis, a once-daily pill used to prevent HIV.īased on this policy, once the subsidies from the drug or copay assistance program are exhausted, a patient would be responsible for the full cost of PrEP until they meet the annual out-of-pocket maximum of their health plan. Copay accumulator programs target the most costly specialty drugs. What is coinsurance What is a copay Learn about different health care costs and the differences between copays, coinsurance, and and out-of-pocket maximums. This relatively new policy from health insurance companies disallows the subsidies that patients receive from drug or copay assistance programs to be applied towards the patient’s deductible or annual out-of-pocket maximum. to investigate copay accumulator programs. This policy will affect many of those who receive infusion therapy, like patients with cancer, arthritis, AIDS, and multiple sclerosis. HRC has joined our partners in the Federal AIDS Policy Partnership in calling on insurance commissioners and attorneys general in all 50 states and Washington, D.C. Beginning on January 1, 2021, UHC will take their copay accumulator policy a step further and also pocket the assistance of patients who receive infusions in their doctor’s office. ![]()
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