Originally posted by Arzosah
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Potential Cost-Savings for MS Meds & US Insurance Deductibles
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ACA supposedly puts a total out of pocket cap on what you have to pay through your plan, but apparently there are exceptions - some companies/plans are given another year to comply, or whatever.
It is not a violation of ACA to charge a $40 co-pay, and there is not requirement that the co-pay be a percentage of the cost of the drug. Putting a co-pay on some expensive drugs is a way for insurers to reduce their costs.
Prior to ACA there was never a requirement for any company to offer health insurance at all and many plans that offered "health insurance" did not cover pharmaceuticals at all. Prior to ACA, insurance companies routinely excluded MS patients, or anyone else with a pre-existing condition that would be expensive for them to cover.
Nothing new here, just another way to reduce costs for the insurance company. But if you have MS and can find a plan with reasonable drug coverage, ACA is a big advantage over not being able to uy a plan at all.
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I just got off the phone with MS ActiveSource an I qualified for the $0 Co-pay assistance plan. I was told the plan is good for 1-year and pays up to $10,000. The discount code is being sent directly to my specialty pharmacy so my next shipment should be covered. My wife and I are so grateful to get financial help with this medication.
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