Copay Accumulator Adjustment Programs

The Issue

Copay cards often help patients with chronic conditions cover the cost of expensive medications. But the impact these cards have is changing as health plans implement what are called copay accumulator adjustment programs.

Under these programs, copay cards still help patients access their medication. But health plans do not apply the value toward a patient’s deductible. Once patients use up the copay card’s balance, they discover that they still owe hundreds or thousands of dollars in out-of-pocket payments before their insurance coverage applies.

That leaves patients with a difficult choice. They can scramble to pay the hefty out-of-pocket bill, or they can abandon the medication they need.

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