Has your doctor ever wanted to prescribe to you a specific
type of medication but the cost does not fit into your budget? Then you may
want to consider asking for a co-pay card from
your health care provider or research their
availability for your specific prescription online. Many pharmaceutical
companies offer discounts on certain medications through co-pay cards, which can allow you to receive the
prescribed treatment at a more affordable cost. Check out the FAQs below to
learn more about how co-pay cards work and how you can possibly find the ones you need.
Co-Pay Cards FAQ
What are prescription
drug co-pay cards?
Co-pay card programs offered by drug manufacturing companies
are a direct way to lower out-of-pocket costs for prescription drugs for
eligible patients. The cards can enable
patients to afford the medications preferred by them and their physicians.
Who
is eligible to enroll in co-pay card programs?
Patients with commercial/private insurance are eligible to
enroll in the program. Co-pay cards are
usually not need-based.
Where do I learn about
co-pay card programs?
Ask your doctor or check with your local pharmacy. You can
also check your medication’s Web site or visit patient assistance sites such as
www.NeedyMeds.org.
How do I enroll?
It’s easy. If your
doctor has given you co-pay card information with your prescription, fill out
the application and send it to the drug manufacturer. If you learned about the program on-line, follow
the enrollment process.
How do I ‘redeem’ a
co-pay card?
Once enrolled in a co-pay card program, the patient provides
his/her co-pay card and prescription to a pharmacy where the pharmacist enters
the information into their systemto submit a claim.
The pharmacist is required to enter the patient’s insurance
number in theprimary fieldand an identifier from the co-pay card
into the secondary insurer field. The patient is instantly provided
withcoverage data, relaying the patient’s out of pocket costs, or co-pay
to the secondary insurer’s benefit manager, who then provides a discount
accordingly. The pharmaceutical company
pays for the program’s cost, including the difference in the patient’s cost.
Can co-pay cards be
used with insurance?
Yes. Co-pay
cards are designed specifically to help with insurance co-payments.
Do I need to have a
particular type of healthcare/insurance plan to be eligible for co-pay cards?
No. Any commercial/private insurance plan offering
prescriptions may use eligible co-pay cards.
Your eligibility depends on the terms of the specific brand co-pay card
program and your insurance plan.
Where can co-pay cards
be used?
Co-pay cards may be used in local pharmacies and are also accepted
by certain mail order pharmacies.
What is the duration of
co-pay card programs?
The duration of co-pay programs varies. The expiration depends
on the parameters outlined by the pharmaceutical company providing the co-pay
card.
What prescription drugs
are offered with co-pay cards?
Most co-pay card programs are designed for more expensive
prescription drugs, but some other older or less expensive drugs have cards as
well. It is best to check with your
physician or pharmacist or on-line to see if your medication has a co-pay
program.
Are there any
restrictions on the use of co-pay cards?
Yes; they cannot be used with Medicare
and Medicaid. Prescriptions eligible to
be reimbursed, in whole or in part, by any federal or state health care
programs cannot use co-pay cards.
Do co-pay cards
increase patient compliance?
By helping patients better afford the medicines prescribed by
their doctors, co-pay programs improve adherence, particularly among elderly
and lower income patients. They also
reduce costs arising from patient non-adherence, such as emergency room visits
and hospitalizations.
How do patients and
healthcare professionals benefit from co-pay card programs?
Co-pay cards help lessen patients’ financial burden making it
more likely that individuals will fill their prescriptions. Offering co-pay cards for prescription
medications provides patients and healthcare professionals with increased
flexibility and choice to ensure the appropriate treatment option is chosen and
attainable by the patient. In addition,
some co-pay card programs offer educational material for patients, providing an
opportunity for greater understanding their condition and treatment.