I have a prescription that is a Tier 3 formulary – $60 copay. I am $10 away from hitting my deductible. I got it approved and then all of a sudden my prescription got discontinued and the price on the Anthem website now shows $3000 that I owe. It was $60 a day ago. Price of Medication now shows as $9000, insurance covers $6000, so I owe additional $3000 on TOP of the copay.
What the actual f***. Isn’t a copay “fixed”? This is not a coinsurance. My Rx plan does not require me to hit a deductible AFAIK, and even then I am $10 away from hitting it. The whole reason I got the Insurance is because I knew this was a Tier 3 Medication not needing a prior authorization. It’s a specialty medication but it’s Tier 3. Multiple people I spoke with confirmed the $60 copay and then a bait-and-switch was pulled at the last minute. How is this legal?!?!?!?
Located in MA.
submitted by /u/schmoozebooze
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I have a prescription that is a Tier 3 formulary – $60 copay. I am $10 away from hitting my deductible. I got it approved and then all of a sudden my prescription got discontinued and the price on the Anthem website now shows $3000 that I owe. It was $60 a day ago. Price of Medication now shows as $9000, insurance covers $6000, so I owe additional $3000 on TOP of the copay. What the actual f***. Isn’t a copay “fixed”? This is not a coinsurance. My Rx plan does not require me to hit a deductible AFAIK, and even then I am $10 away from hitting it. The whole reason I got the Insurance is because I knew this was a Tier 3 Medication not needing a prior authorization. It’s a specialty medication but it’s Tier 3. Multiple people I spoke with confirmed the $60 copay and then a bait-and-switch was pulled at the last minute. How is this legal?!?!?!? Located in MA.
submitted by /u/schmoozebooze [link] [comments]Read Morer/HealthInsurance