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.

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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.

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.

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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.