Copay Assistance Program

Hey! I recently began a specialty drug that costs me $4,370 a month. The drug manufacturer has an $18k copay assistance card to help cover these outrageous costs, but my health insurance has a copay accumulator which does not accept copy assistance toward my Out of Pocket Max Deductible. For August & September doses of the medication, I’m straight up using the copay assistance to pay. For October & November I will pay for it out of my own pocket, and submit a reimbursement claim to the manufacturer for reimbursement.

My question is this. As aforementioned, I directly used the copy assistance card to pay for the drug for August, but the amount paid is showing as counting toward that OOP Max Deductible. I’ve read that insurance will oftentimes count it, and then eventually remove it from your OOP deductible. I’m wondering if anyone has any idea how long it typically takes the insurance company to remove the amount from your overall “deductible met” progress? Thank you so much!

submitted by /u/raskolnikovs_guilt
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