DPAC (Diabetes Patient Advocacy Coalition) is seeking patient stories for individuals who have been negatively impacted by a Copay Assistance Accumulator Program (CAAP) included in their insurance plan.
A CAAP is where a manufacturer provides a coupon to a patient to enable them to purchase a drug at retail for a discounted amount; however, the patient does not get credit towards their deductible or out of pocket max for the amount of the coupon by their insurance plan. The result of this is that the plan gets the deductible paid twice – once by the patient and once by the manufacturer through the coupon – and patients are faced with paying full list prices after the coupon expires, often making their medications unaffordable.
DPAC has been asked to gather as many patient stories as possible for individuals who have been harmed by a CAAP as part of an effort to show the impact of these unfair programs. Note that this does not need to be on insulin or even a diabetes drug. It can be for any prescription drug where the patient used a manufacturer’s coupon but did not get credit for the coupon against their deductible or out of pocket max.
Some examples of being impacted by a CAAP are:
- You use a copay card to purchase a medication, but you do not see this purchase reflected on your statement that tells you how close you are to meeting your deductible.
- You use a coupon for a drug that would’ve cost you $150 but only costs you $20. When you check to see how close you are to meeting your $2,000 deductible, you still have $1980 left to pay instead of $1850.
- You have a $2500 deductible and take a medication each month that costs $500. You receive a coupon for the medication that gives you a $400 discount, so you only pay $100 over 5 months. You expect that you will meet your deductible in May, 5 months into the year. In June, you learn that you still owe $2,000 to meet your deductible because none of the assistance counted toward your deductible – only your $100 out of pocket payments counted.
Please let us know if you’ve experienced something like this by sending a note to [email protected] and they will follow up with more information. If this has impacted someone you know, DPAC would love to hear from them also — please share this page!
If you’re unsure if this applies to you, please contact us and we’ll be happy to talk through it with you.
You can learn more about CAAPs by checking out DPAC’s Brown Bag Series replay!