The Patient Advocate Foundation could help pay your drug copays

Copays used to be a reminder of how nice it was to have health insurance. Now, too often they are a reminder of how little insurance we really have.

Not long ago, copays for prescription drugs were almost universally small, flat fees — as little as $5, no matter how expensive the medication you required.

The original rationale for the copay was to prevent people from seeking unnecessary care, such as visiting the doctor whenever they had the sniffles. The underlying assumption was that without a small copay, consumers would view medical care as “free” and overuse it.

That may have been the original reason for copays. But it’s not the reason anymore.

Today, those “small” flat fees have grown to as much as $50 or more per 30 day prescription — and that’s not the half of it.

Now, many insurers are demanding that patients pay co-pays based on a percentage of the retail price of expensive medications — as much as 33 percent or more of the total cost.

As has reported:

Hundreds of drugs are now being priced this new way. These drugs are used to treat diseases that are fairly common, including multiple sclerosis, rheumatoid arthritis, hemophilia, hepatitis C and some kinds of cancer. Unfortunately, there are no generic equivalents for these drugs, so patients are being forced to pay these prices or go without.

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People are “going without” because the new copay system means that some patients are required to pay thousands of dollars out of pocket for their prescriptions — even though they have insurance.

It makes you question the very definition of insurance, doesn’t it?

Fortunately, for those who are struggling with co-pay expenses, there is a non-profit organization called the Patient Advocate Foundation (PAF) that can help.

The PAF Co-Pay Relief Program provides direct financial assistance to insured patients, including Medicare Part D beneficiaries, who qualify based on medical and financial criteria. The program offers personal service through phone counselors, who guide patients through the enrollment process.

The patient assistance program helps insured patients who are being treated for the following conditions: breast, lung, lymphoma, prostate, kidney, colon, pancreatic, and head/neck cancers; malignant brain tumor; sarcoma; diabetes; multiple myeloma; myelodysplastic syndrome (and other pre-leukemia diseases); osteoporosis; pain; hepatitis C; rheumatoid arthritis; selected autoimmune disorders; and CIA/CIN.

If you are struggling to afford your drug copayments, call the PAF Co-Pay Relief Program at 1-866-512-3861 or apply for help online.

About Cary Byrd

eDrugSearch founder, Cary Byrd, has been called an “e-health innovator” by MarketIntellNow, interviewed by top pharmaceutical industry journalists, invited to Matthew Holt’s Health 2.0 Conference and a Consumer Report's health summit, and highlighted on numerous health blogs. - Search. Compare. Save.

0 thoughts on “The Patient Advocate Foundation could help pay your drug copays

  • I found out that Alprazolam is also known under the genaric name Xanax, Xanor, Alprax, and Niravam.

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  • I attempted to do the application for assistance and the site was blocked as “unsafe and not secure”? I recently changed insurance companies from Cobra to my husbands. The copay’s are tremendous due to a high deductable. At this point I can’t afford two of the copays and I am at a lost as to what to do! These are medications that I cannot go without, out of desperation I found your website and thought it would be worth a shot.
    Thank you so much for anny assistance you might be able to offer.
    Thank you,
    Jean Laird

  • i’m retire on disability and only get $1,204 a month.i’m paying cobra $417.16,rent is $500 there’s utilities etc and i’m haveing a hard time paying for the cobre and prescriptions co-pay.can you help me in any way? thank you for your time

  • I take Brovana nebs and Pulmicort nebs which are part B drugs. Cost of copays for both is $120. I get only $1051,medicare premium $104.90 and $91 for part b and d.Out of that comes rent$600, $350 car payment. Leaves me with nothing for miscellaneous. How are people suppose to live?

  • So my parents are on a fixed income and just found out today the insurance company switched from CVS to Scripts pharmacy and now are not sending my dad his meds which keep him alive. They went from an annual copay of $1500 to scripts wanting a 25% of drugs retail price which would now cost $1500 a month, just like that. How?? I mean I can’t even begin to describe the level of stress we all feel right now. What now?

  • Karen zalewski says:

    I have blue cross/ blue shield (ppo) n have to pay for my own co-pay which is really high. I am trying to find Ann insurance that will help me with my co-pay. I can hardly make ends meat now. My prescription co-pay foe one is high n they will not pay for my script. Thank u Karen zalewinski

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