Voices Across America

Copay Accumulator program now costs me $3000 a month!

stones avatar


State: California
Congressional District: CA29


Chronic Pain, Endocrine Disease, Gastrointestinal Disease, Immune Disease, Skin Disease

Issues and Challenges

Lisa has encountered: Copay Issues, Insurance Issues, Copay Accumulator, Financial Assistance, Invisible Illness, Prior Authorization

My Story

I have multiple auto immune diseases and have been using co pay assistance cards through Otezla for years. My doctor wants to switch me to Taltz and we have to go through 2 months of back and forth with UHC to get it approved. Once it was approved they told me they do not accept cop pay assistance cards and my copay for the medication would be $3,000. How can anyone afford that kind of money for an RX - that's more than my mortgage? I have called multiple times and have been advised the medications are specialty meds that are on an exclusion list and are not eligible for copay assistance.

The flyer from UHC advises :
You can continue to use this card at Optum® Specialty Pharmacy to help reduce your out-of-pocket costs. But, the dollar value of the card will no longer apply toward your deductible or out-of-pocket maximum under your plan. Only the dollars you actually pay out of pocket will count toward your deductible and out-of-pocket totals.

But that is not the case - they won't even accept the co pay card.

All this while UHC has shown record profits but they want more, and sadly they have made an internal decision that the best place to get it is off the backs of chronic disease patients. After posting $4.1 billion in profit in the fourth quarter of 2021, UnitedHealth Group ended the year with $17.3 billion in total profit, according to the payer's latest earnings report. The company's full-year revenue grew more than $30 billion, or 11.8%, to $287.6 billion year over year (YOY), with growth seen especially in the Optum, which handles RX and specialty drugs, and UnitedHealthcare businesses. Full-year earnings from operations were $24 billion, with Optum accounting for more than half of that total.

My Motivation and Inspiration

UHC, big pharma and insurance companies are making record profits while those with chronic conditions can no longer afford their medications.

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