A new insurance policy could prove harmful to HIV patients and others living with chronic disease, who need to access and adhere to daily medications.
Several insurers and employers are no longer allowing co-pay cards from drug manufacturers, which many patients use to lower their out-of-pocket costs, to count towards a patients’ deductible.
Patient cost-sharing has soared in recent years.
The average deductible for individuals with employer-sponsored health plans has more than doubled in the past decade, rising from $616 in 2007 to $1,505 in 2017.
People who have coverage through the Affordable Care Act exchanges face even higher deductibles -- the average exchange-plan enrollee must pay his first $4,000 in health bills completely out of pocket.
HIV medications can cost more than $25,000 per year. At the start of the year, patients could easily face out-of-pocket costs of $2,000 or more per month until they hit their deductibles.
Fortunately, most drug companies offer coupons, often known as “co-pay cards.” Patients can present the cards to pharmacists, and the pharmacy will bill the drug company for most or all of the co-pay that patients owe their insurers.