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Does copay assistance work with coinsurance?
Apr 14, 2014

Under my new insurance my Meds are Tier 5 specialty so I'll have to pay a percentage of coinsurance. It's worked as coinsurance, not copay.

Because of this difference will my copay assistance programs with Truvada and Reyataz still work?

The spirit of those assistance programs is to help those who can't afford their portion of the payment. Will the category change from copay to coinsurance change that?

Response from Mr. Chambers

AIDS Drug Assistance Programs (ADAP) vary by state, and I assume this is the copay assistance program you're speaking of. Generally, the answer to your question is that ADAP will pay what the insurance doesn't pay as long as the medication is on the ADAP formulary. That would be whether it is a copay or coinsurance percentage.

You should confirm that with the ADAP program in your states. Or check with your pharmacist. He or she should know.

If you were not speaking of an ADAP program, give me the details of the program and I'll try to confirm it.

Good luck, Jacques

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