I’m likely going to be moving from my employer plan to a bronze or silver aca plan. I’m trying to figure out what this means for my enbrel prescription in terms of cost and what the worst case scenario is as I’m not sure if this will be covered by a standard plan?
Do specialty medication costs count towards out of pocket maximum? Eg is the worst case scenario that I can’t get a plan to cover the enbrel or copay assistance and my costs for the year end up capped at the max annual out of pocket ($8,200)?
Also does anyone know what criteria enbrel uses to decide how much copay assistance you qualify for?
submitted by /u/RogerFlo
[link] [comments]
I’m likely going to be moving from my employer plan to a bronze or silver aca plan. I’m trying to figure out what this means for my enbrel prescription in terms of cost and what the worst case scenario is as I’m not sure if this will be covered by a standard plan? Do specialty medication costs count towards out of pocket maximum? Eg is the worst case scenario that I can’t get a plan to cover the enbrel or copay assistance and my costs for the year end up capped at the max annual out of pocket ($8,200)? Also does anyone know what criteria enbrel uses to decide how much copay assistance you qualify for?
submitted by /u/RogerFlo [link] [comments]Read Morer/HealthInsurance