Background – What Are Co-Pay Cards? 

Pharmaceutical manufacturers have offered coupons, also known as “co-pay cards,” to help offset the cost of many prescriptions. These coupons are often used for essential medicines that prevent HIV and treat HIV. Since there are no generic alternatives in many cases, these co-pay cards have helped many people pay for their medicines. Insurers have traditionally counted these coupons towards a patient’s deductible. For those who have a lower deductible, these co-pay cards can help a person reach their health plan’s deductible. 

The Situation – Co-pay Cards Counting Towards Deductible

Now, some insurers have changed these policies, no longer counting these coupons toward a person’s deductible. Some plans are refusing to accept co-pay cards at all. This shifts costs directly onto patients and is going to affect patients’ access to their prescriptions. High out-of-pocket costs prevent many patients from adhering to these essential medications. For those living with HIV, skipping just 2-6 days of medicine can boost viral loads by 25 percent. A resurgent virus can result in a host of health complications. Pre-Exposure Prophylaxis, or PrEP, can prevent HIV infection by 92 percent if taken daily. For those using this medication, missing a dose may increase the likelihood of contracting HIV. In addition, if you become HIV positive while on PrEP, your HIV virus may be resistant to some of the medications used to treat HIV. 

The Solutions – Raise Awareness

That’s why HealthHIV and the National Coalition for LGBTQ Health are concerned about co-pay cards not counting towards your deductible and advocating to make #CoPaysCount. Here’s what you can do to get involved:

• Sign the #CoPaysCount Petition
• Share your story with us
• Read the latest Advocacy Brief, May 28, 2020: Urge HHS to Reverse New NBPP Increasing Out-of-Pocket Drug Costs

Join us on Social Media

• Extend the message to show #CopaysCount

Resources

• Copay Accumulators: Costly Consequences of a New Cost-Shifting Pharmacy Benefit
• Warning: Your Copay Assistance Card May Not Count Towards Your Deductible
• Co-pays Can be the Difference Between Sickness and Health

For any questions or more information, contact Scott Bertani at scott@healthlgbt.org.