Voices Across America

My Patient Story

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Jack

State: Virginia
Congressional District: VA 1

Diseases

Endocrine Disease

Issues and Challenges

Jack has encountered: Copay Issues, Out of Pocket Costs, Copay Accumulators

My Story

Last year my employer decided to implement a copay accumulator. They did not tell us this would be done until after I signed up for coverage. For 10 the years prior, I had a copay assistance program with a drug company that manufactured a biologic medicine for treating psoriasis. This was a miracle drug at the time for me because no other treatment had really helped. My copay was 2000.00 at the time. The copay assistance paid for with a credit card, it so my copay was zero for the rest of the year. No co pays for insulin or thyroid etc. Fast forward to 2020 and my employer now says the copay assistance is no longer counted towards my out of pocket totals. Yes, the drug company will pay for the psoriasis medicine, but now I have to pay 800 per insulin prescription filled until I pay the 4500.00 copay. So even if the copay is paid by the drug company y, it does not count toward my out of pocket because I did not personally pay for it. The difference between me or the drug company paying for it? No idea. Supposedly this was done to encourage people to switch to generics to keep drug price costs down. My insulin and psoriasis medicines do not have generics but I am still being punished.

My Motivation and Inspiration

My motivation and or inspiration is knowing that there is someone battling the system for me. For the last 7 months I have been feeling frustrated and helpless because I had no way of being heard or voicing my opinion. Luckily, having Patients Rising reach out to me letting me know they are fighting for me, and people like me, was encouraging and invigorating .

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