Dupixent prescriptions are not counting towards my deductible.
Hello all I would greatly appreciate assistance on this matter.
Age: 25 Zip code: 77019 Income: $65,000
I’m in the state of Texas.
I am prescribed Dupixent for severe eczema. I have employer insurance, Blue Cross Blue Shield PPO Plan with a deductible of $3200.
From what it appears based on what the blue cross support specialist told me, the specialty pharmacy, Accredo, is reversing pharmacy claims, even though I’ve received my prescriptions. This is preventing me from meeting my deductible.
I do have a dupixent my-way card that pays the rest of the balance. I was told that whenever insurance companies reverse claims due to manufacturer co-pay cards, it is called a “copay accumulator.”
Based on my research, this is illegal in several states. In fact, it became illegal in the state of Texas in September of 2023.
I am wondering for advice on any next steps. Do I contact the specialty pharmacy and demand that they stop reversing my claims? So far my experience with them has been terrible, what do I say to them etc. Or do I reach out to my insurance again? Any and all help would be greatly appreciated.
submitted by /u/theroadto120
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