Let’s say Novolog costs $270 cash price. For this example, let’s assume Novolog to be a covered benefit by your policy with a 20% copay & you have no prescription deductible to meet.
Lets see how the co-pay card helps:
Terms: Card will pay up to $100 toward your co-pay. You are required to pay a minimum co-pay of $25. This card only worx if Novolog is covered by your insurance plan.
Co-Pay: For a 30 day supply of Novolog you would pay $54 (20% x $270), however by using the co-pay card you would pay only $25.
Savings: $29 ($54 co-pay-$25 discount). You have the additional advantage of having the entire $54 regular co-pay that will go toward meeting your deductible as if you had paid it. Of course insurance will pay the remaining 80% of the cost of the drug or $216
Let’s say Ozempic costs $700 cash price. Assume it is covered on your insurance plan, however you have a $1400 pharmacy deductible to meet.
Terms: Card will pay entire cost of medication even if not on your formulary.
Co-Pay: Your co-pay for a 30 day supply of Ozempic is $0, while $700 will go toward meeting your deductible. You will meet your deductible in 2 months and pay nothing in this example.
Lets say Trulicity costs $750 cash price. Assume it is not covered by your prescription benefit.
Terms: This card will give a cash discount for medications not covered by insurance of up to $150. Your cost at the pharmacy will be $600/month ($750-$150).
In this example, because there no insurance coverage, the card helps very little. You would only pay $25 if it was covered and your co-pay was less than $175. As you can see the terms, insurance & cost of the medication contribute to how much you will pay at the pharmacy counter.
Be aware than your insurance may not cover a medication, supply or service at all and therefore your cost will be the retail price. Also uncovered expenses will not go toward your meeting your deductible amount. If this is the case it may be cheaper to go with a drug or device on your insurance formulary or use a co-pay card whose terms to not require insurance.