OptumRx Specialty Pharmacy
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My wife takes a specialty drug that’s 3000 a pop. Insurance won’t cover anything until the deductible is met then it’s $75 a fill after that. The manufacturer has a program they give enough funding on a “co-pay card” which is designed to pay to meet the deductible and able to cover the fills for the year. Unfortunately but unsurprisingly optum’s stance is paying with the card doesn’t go towards anything, neither deductible nor out of pocket max. Any advice on how to try and navigate their asinine view on this? Why does it matter if I pay for it Vs the manufacturer paying?
#2
My wife takes a specialty drug that’s 3000 a pop. Insurance won’t cover anything until the deductible is met then it’s $75 a fill after that. The manufacturer has a program they give enough funding on a “co-pay card” which is designed to pay to meet the deductible and able to cover the fills for the year. Unfortunately but unsurprisingly optum’s stance is paying with the card doesn’t go towards anything, neither deductible nor out of pocket max. Any advice on how to try and navigate their asinine view on this? Why does it matter if I pay for it Vs the manufacturer paying?
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