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Copay Assistance for Leukemia Drugs

Posted on March 22, 2022
Medically reviewed by
Richard LoCicero, M.D.
Article written by
Joan Grossman

Leukemia treatment can be expensive — even with insurance, due to the cost of copays and deductibles. Drugs that are used in chemotherapy and targeted therapy account for one-third of costs associated with the treatment of leukemia, and out-of-pocket expenses can add up. For many people, these costs can be a burden, especially as prices for these drugs continue to rise.

Copays are a topic of concern on MyLeukemiaTeam. “I am supposed to start treatment sometime in August. Not sure what it will be, as the one my doctor proposed has a very high copay,” a member wrote.

Another member said, “I am up early having coffee, looking online for help with my copay for my medication.”

For people with leukemia who need help with out-of-pocket expenses such as copays and deductibles, copay assistance programs may be able to help cover some of the costs associated with treatment.

What Is a Copay Assistance Program?

Copay assistance programs are programs for people with insurance who still have out-of-pocket expenses for medical treatments due to copays and high deductibles. These programs can help cover the costs of:

  • Prescription drugs
  • Copays
  • Deductibles
  • Medical insurance premiums
  • Coinsurance

Some programs have household income requirements, and you will qualify only if your income is below a certain limit.

Some copay assistance programs are operated by organizations that distribute financial support for copays and other expenses related to a medical condition. These programs may provide direct payments to drug or health care providers. They also may provide reimbursement for payments already made.

Other programs, such as prescription drug savings cards, copay cards, and copay coupons can provide immediate rebates for prescription drugs when you purchase them at a pharmacy. Prescription savings cards helped save Americans more than $200 million between 2009 and 2016 — an average of $18 per prescription. These programs are generally designed for people with private insurance, and they do not apply to people on Medicare or Medicaid.

Many drug companies also provide direct assistance to help reduce the cost of medication, for those who qualify. These programs pay some or all of a person’s out-of-pocket expenses, once their insurance company has paid its portion. With some insurance plans, these payments may count toward your annual deductible or maximum out-of-pocket payment limit.

What Copay Assistance Programs Are Available for Leukemia Drugs?

Numerous savings programs are available for people with leukemia to offset some of the costs for drugs and cancer treatment. Copay relief programs can have different requirements and limitations depending on which state you are in. You may want to ask a caregiver or social worker to help determine which program may be best for you.

“The social workers at my cancer clinic helped me to apply. Since getting the grant, I have had almost all prescription copays covered,” a MyLeukemiaTeam member said.

Ask your doctor or pharmacist about copay assistance programs and other forms of financial support that may be available for the drugs you need. They may be familiar with programs that offer support for leukemia drug expenses.

Organizations That Provide Assistance

Several nonprofit organizations have copay assistance programs that provide support to people with leukemia. In some cases, funds for specific types of leukemia may have been allocated for the year or they may not be available. However, you can still contact the organization to find out when new funding may be open again.

You can refer to these organizations, among others, for more information on their programs, eligibility criteria, and application process:

“Try the Patient Advocate Foundation's copay relief program,” a MyLeukemiaTeam member said. “They have funding programs that open and close throughout the year for different types of cancer. I secured a grant from them to help pay for the cost of my chemotherapy drugs and the administration costs to administer the chemo.”

Another member wrote about their successful application with the Leukemia & Lymphoma Society: “They even handled the submission. It really was easy. But they only cover the copay, which in my case was about $600 a month.”

NeedyMeds, a nonprofit that connects people with resources to pay for medications, offers a free Patient Assistance Program Update Service with daily and weekly email reports on changes to programs, applications, and eligibility requirements.

Consult an Online Aggregator

An online aggregator is a digital library or database that can help you search for copay assistance for specific drugs and pharmaceutical companies. These tools may provide discount cards or coupons for drugs that you need.

GoodRx offers a mobile app to help you locate the pharmacy in your area with the best price for the drugs you need. Drug costs are not regulated in the United States and prices can vary considerably. This tool, and others like it, can help you save money.

The Pharmaceutical Research and Manufacturers of America also provides detailed information and tools for accessing copay savings programs.

Copayment Assistance from Drug Manufacturers

Drug manufacturers with copay assistance programs will have information on their websites. Copay assistance grants from drug manufacturers are typically limited to people with private insurance. Visit the website for a drug your doctor has prescribed, and look for menu options such as:

  • Copay assistance
  • Financial support
  • Insurance coverage
  • Manufacturer coupon
  • Savings card

Don’t hesitate to call a drug company and ask about their copay assistance programs. One of their representatives can talk to you about the programs they offer, eligibility requirements, and how to apply. The doctor who prescribed your medications may need to provide the manufacturer with information about your prescription.

“My copayment was $500 but Biotech Pharmacy found me a secondary source and I pay nothing for this medicine,” wrote a MyLeukemiaTeam member. “Check it out. There are a ton of options out there.”

“I too had an issue with my copay being $1,300 a month. I couldn’t afford to pay,” another member said. “My doctor’s office helped me contact the manufacturer and they are helping me with the copay. You should have a patient advocate in your doctor's office who can help you with this.”

Can You Get Copay Assistance if You Have Medicare or Medicaid?

People with Medicare Part D, which offers prescription drug coverage, may qualify for copay assistance if they meet certain requirements..

If you would like more information about Medicare Part D drugs and prescription coverage, call 800-633-4227 or search for your state insurance department. If you are eligible for both Medicare and Medicaid, you may have more options.

Copay Accumulator Programs

Some private health insurance plans may have a copay accumulator program. With copay accumulator programs, the amount paid by a drug manufacturer will not count toward your deductible and out-of-pocket maximum under your health plan.

If your health plan has a copay accumulator program, you may still owe a significant amount of money toward your deductible after reaching the maximum annual amount offered by your copay assistance program.

Ask your insurance provider or your employer’s human resources administrator if your health plan includes a copay accumulator program. If so, be sure to talk to your employer if you need help paying for drugs due to high costs.

Copay accumulator programs are controversial. Several states have passed or introduced legislation to ban or restrict them.

What if You Don't Qualify for Copay Assistance for Leukemia Drugs?

If you are uninsured or your health plan does not support a copay assistance program for your leukemia drugs, you may want to ask your doctor about other drugs with lower out-of-pocket costs to treat your condition.

Learn how to get leukemia treatment if you don’t have insurance.

Talk With Others Who Understand

On MyLeukemiaTeam, the social network for people with leukemia and their loved ones, more than 10,000 members come together to ask questions, give advice, and share their stories with others who understand life with leukemia.

Are you living with leukemia and have questions about copay assistance? Share your thoughts and experience in the comments below, or start a conversation by posting on your Activities page.

All updates must be accompanied by text or a picture.
Richard LoCicero, M.D. has a private practice specializing in hematology and medical oncology at the Longstreet Clinic Cancer Center, in Gainesville, Georgia. Review provided by VeriMed Healthcare Network. Learn more about him here.
Joan Grossman is a freelance writer, filmmaker, and consultant based in Brooklyn, NY. Learn more about her here.

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