Anthem Cost Relief
Anyone have experience with this program?It took some digging to find this information as they are not transparent about this program at all. Its manged by a company called PrudentRx. PrudentRx has to be one of the worst programs designed in the fight between the PBMs and Drug Manufacture on drug costs. As it's designed to milk as much money out of the assistance program it can all while PrudentRx skims a healthy chunk off the top for their profits. Even if you have an out of pocket limit this program says that no longer applies through a slimy loophole that the useless government with all this big business have in their pocket arranged.
Have to meet the deductible before the program even applies. Then once you do none of the manufacturers assistance applies to you out of pocket. So still stuck with the high cost of all other medical bills.
Because certain specialty medications do not qualify as “essential health benefits” (EHB) under the Affordable Care Act (ACA). member cost share payments for these medications, whether made by you or a manufacturer copayment assistance program, do not count towards the Plan’s Max Out Of Pocket(MOOP). So what that means is that they will repeatedly charge your coinsurance even if you have meet your MOOP through other costs and continue to collect patient assistance until they milk it dry even though the patient should no longer require the assistance. So while they are charging you $0 and you are still responsible for the deductible and all other MOOP amounts PrudentRx is still raking in those patient assistance dollars that are now providing no assistance to the actual patient.
These patient assistance programs are available even without Prudent it just requires going to the individual manufactures program website. Even though they may state it's optional, in reality if you don't sign up it could end up costing you thousands extra to not enroll because of the above loophole.
Old article but these programs seem to be coming more common.
https://www.drugchannels.net/2020/05/why-do-cvs-and-express-scripts-rely-on.html
submitted by /u/Gold-Shine6354
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