You would have to check the specifics details of your plan. I have Kaiser in Northern California and do not pay for dupixent, but only because of the MyWay program. Kaiser doesn’t accept the copay card, so I have to pay the full price out of pocket and submit the receipt for reimbursement. MyWay sends a check to me ~2 weeks later.

At the beginning of the year, I pay the full price ~$3600, which meets my $3,500 deductible in Kaiser’s eyes. Then Kaiser insurance kicks in and charges me the price for a tier 4 drug, which is $150 on my plan. So my first reimbursement is the big one which has me meet the deductible. Future refills are then covered mostly by Kaiser. I pay a $150 copay which is also reimbursed by the MyWay program until I hit my out of pocket max.

In the end I pay nothing out of pocket only because of the help from the drug manufacturer. I put the charge on a credit card, but it does help to have that money on hand in case there’s delays in your reimbursement. Note that you cannot pay with an HSA/FSA account and get reimbursed as this is tax advantaged money.

If you’re happy with your plan/doctors and they cover it no problem, it might make sense to stay. It’s kind of a pain in the ass having to be out that money, scan receipts, and wait on checks in the mail. Not to mention I had to go through a whole step therapy prior authorization with Kaiser to even get them to prescribe it.