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HSA / high deductible / high out of pocket insurance.
Feb 1, 2013

I do not qualify for any insurance assistance programs due to my salary. My insurance at work changed to a HSA policy with a $1500 deductible and $4000 out of pocket. I also just priced my meds under the new plan. The first time I fill the drugs it will be over $3200. After that, I will be responsible for 30% of total drug costs. Thats just for the HIV meds I'm taking. I do take advantage of copay assistance from the manufacturers. Because of having to use (they dont take the copay cards) I have to file a form and get reimbursed. That leaves me with the problem of coming up with the money upfront. I've talked to the resources available to me in my area and it seems there arent any options left for me. Do you have any advice?

Response from Mr. Chambers

I wish I had a direction to point you towards. It sounds like you don't qualify for ADAP due to income, and you are already taking advantage of the manufacturer discounts available to you.

Your issue is having to pay up front and get reimbursed. How long does reimbursement take? Is it quick enough that you can charge the medications and get reimbursed in time to pay the credit card bill when it comes?

Is your pharmacy a private one or part of a big chain? If you are lucky enough to be dealing with the owner of the pharmacy, have you tried to work out an arrangement with him/her to wait for payment until reimbursement arrives?

As you can see, I'm really grabbing at straws here. The normal safety nets available to many, don't apply to you. By having your health insurance through an employer, you have no control over what type of coverage you are under.

Is your salary and budget such that you can deposit money into the HSA? That will at least give you the advantage of paying for your medications with before tax dollars.

I'm afraid I am like your local resources; I don't have a good alternative for you.

I'm so sorry, Jacques

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