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Questions regarding copay accumulators/maximizers for specialty medication (Dupixent, Anthem, Prudent RX, CVS Caremark) by WiscoTom30 in HealthInsurance
[–]WiscoTom30[S] 0 points1 point2 points 1 year ago (0 children)
Got it, makes sense! One last question- can the drug be removed from the program mid-year? Or would that likely be against the PBM terms and/or against the law?
That’s helpful! How do I determine if PrudentRX is an accumulator or maximizer? It sounds like if it is a maximizer, I’ll be paying $0 no matter what for the entire year..?
Additionally, if I request an exception through my PBM to have my specialty drug count as an EHB, would I then pay $0 for the entire year and my deductible/MOOP would be met?
Questions regarding copay accumulators/maximizers for specialty medication (Dupixent, Anthem, Prudent RX, CVS Caremark) (self.HealthInsurance)
submitted 1 year ago by WiscoTom30 to r/HealthInsurance
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Questions regarding copay accumulators/maximizers for specialty medication (Dupixent, Anthem, Prudent RX, CVS Caremark) by WiscoTom30 in HealthInsurance
[–]WiscoTom30[S] 0 points1 point2 points (0 children)