Well, I started getting
calls from patients
who were trying
to get their medications.
They'd go to
the pharmacy counter
and they were being told
that it would be
thousands of dollars
to get the medication
that they're used to paying
$30, $40, $50
whatever their copay was.
They were learning that
a copay accumulator
had been applied
to their policy.
This is a new thing
insurance companies are doing
where
if you have
an expensive medication
if you have multiple sclerosis
or any of these conditions
that have expensive medications
manufacturers
will frequently provide you
with copay assistance.
So what they do
is they give you a card
and when you go
to the pharmacy counter
you present that card
and the manufacturer
is actually paying
for your medication
until you get to the point
where your doughnut hole
has been
your deductible
has been filled
and then at that point
you're just paying the copay.
Insurers have started
taking the money
that is being paid
by the
pharmaceutical manufacturer
but not applying it
to the patient's deductible
and not telling the patient.
So the patient goes up
they think they're going
to pay their copay and
it's $3,000, $4,000, $5,000.
The one
that really struck me
was a woman
with a heart condition
who needed this
heart medication to live.
She went up
like she always does to
buy her medication.
They said it was
gonna be $3,800.
They didn't have $3,800
and her husband
had to go to the bank
and take out a loan
so she could
get the medication
she needs to live.
And I realized
we have a problem here.
That woman
who I've come to know
her family is going into debt
more and more every year.