Copay Accumulators 101 – Everything You Need to Know for Effective Patient Advocacy скачать в хорошем качестве

Copay Accumulators 101 – Everything You Need to Know for Effective Patient Advocacy

When patients cannot afford their medications, they may rely on financial assistance, often called copay assistance, from pharmaceutical manufacturers and other third parties to meet their health plans cost-sharing responsibilities and fill their prescriptions. Typically, copay assistance can contribute to a patient’s cost-sharing requirements including the patient’s deductible and annual out-of-pocket limit. However, health plans can implement copay accumulator programs which prohibit the copay assistance from counting towards the patient’s cost sharing requirements resulting in increased costs for patients. In recent years, health plans have created and modified the typical copay accumulator programs in the form of copay maximizers and programs that classify certain prescription drugs as non-essential health benefits. High deductible health plans (HDHP) with health savings accounts (HSA) have also imposed additional barriers to accessing copay assistance as a result of the Internal Revenue Service’s interpretation of its 2004 Notice relating to discount cards. Hosted by Aimed Alliance, a not-for-profit health policy organization, this webinar will provide patient advocacy groups an overview of how copay accumulator programs operate as well as information and resources for patient advocacy groups interested in engaging on this issue. This webinar will provide attendees with: An overview of copay accumulator programs; An explanation of how copay accumulator programs and copay maximizer programs are similar and distinguishable; An explanation of how some health plans define specialty drugs as non-essential health benefits under the Patient Protection and Affordable Care Act (ACA); An overview of the 2004 IRS Guidance and its impact on HDHP HSA plan beneficiaries; An opportunity for attendees to ask questions on the varying copay accumulator programs; and information and resources for organizations looking to get more engaged in copay accumulator reform.