Health Insurance Deductible Question with Drug Co-Pay Assistance?

Hi there,

My wife and I have a health insurance plan through the insurance marketplace. She has Crohn's disease so we opted to get the plan with the smallest deductible.

She has already hit her deductible spend of $1500 however we've spend nowhere near that amount in out of pocket costs, so I've been trying to figure out what's been going on.

Here is what I think has happened but wanted to see what others thought. She is on Stelara once a month, the co-pay for that drug is $1K however the drug manufacture provides co-pay assistance which brings her total payment for the injections to only $5/month. Is the co-pay assistance from the drug manufacturer going towards her deductible?

That's what I think is happening, and wondering if I should go for a lower tier plan next year considering the $12K would go towards her deductible even though that would be paid by the co-pay assistance.

submitted by /u/Nistoi
[comments]