SaveOnSP may have repeatedly paid by mistake

My prescription drug plan is express scripts, and I also have coverage from SaveOnSP through my employer. I’ve been taking a drug (filled by Accredo) that my primary health insurance does not cover, and it costs about $20K a year. The copay assistance program for the drug covers $15K a year, and SaveOnSP covers the remaining amount.

Everything worked perfectly in 2021 and 2022. This year, I messed up and did not reapply for the copay assistance program at the beginning of 2023. I thought I did, but it turns out I didn’t. I am a fool, and the program doesn’t communicate with you at all.

Express scripts emailed me in February telling me I owed money, which got my attention. I called Accredo, and they looked at my account. They told me I was covered and sometimes express scripts is not up to date on things. My balance went down to zero.

Accredo did not tell me who paid the bill, and I assumed it was the copay assistance program because I was confident that I reapplied. In my express scripts billing history, it showed a couple unpaid refills, then the next entry said “memo” (no details), and the next entry is a credit for the entire balance.

A couple days ago the same thing happened, I got an email from express scripts saying I owed thousands. I called Accredo, they looked into it, they said I was covered, and my balance went to zero again. This time they mentioned SaveOnSP, though, and I thought that the copay assistance program money should not have been exhausted yet.

When I asked the Accredo rep to confirm that everything was taking place the way it should, she contacted SaveOn, and SaveOn confirmed that they are paying the bill and will continue to cover me.

See also  Florida Medicaid with Private Insurance - doctor doesn’t accept the private insurance.

It dawned on me later that I did not properly reapply for the copay assistance program for 2023. By my reckoning, SaveOn should not have paid any of the bills this year. I am not 100% sure of everything but am starting to become very concerned.

My balance is currently $0 with both Accredo and Express Scripts. I made sure that there are no refills pending with Accredo. Once I highlight to SaveOn that I’m no longer enrolled in the copay assistance program, I predict that I will owe money for all refills from this year.

Is there any path for leniency here? The reps on the phone kept saying everything was good and my bills kept getting paid.