So for 2 1/2 years I've been jacked up like a spider monkey on cutting-edge cancer drugs, and they work.
Years 1 and 2 we maxed our out-of-pocket pretty fast, and just paid it.
This year we got 9K Copay Assistance from the Drug Maker (Pfizer) which should have covered what our out of pocket was. 'Cept we got a bill for almost that much from Accredo (pharmacy.)
What had happened was, it's a Tier 5 drug meaning insurance pays 70% and we're due for the other 30%. So in February and March, we got a 20K bill each month, insurance (Viva) paid 14K each time, and we had 6K each month we were due. Except we never heard about it, because Accredo took our 9K from Pfizer, paid it all out, then we owed them almost 3K left over, then almost 6K more in April, so now we owe almost our max out-of-pocket.
My question: What the fuck difference did it make to get the Copay Assistance from Pfizer? We'd owe the same out-of-pocket without it.
I think Accredo misapplied it. We have a friend who went through similar, and got a Pharmacy Liaison to get on a three-way call with Accredo to straighten them out. Our luck so far is getting bounced around between the three main entities, and there's no point arguing with clerks.
I am going to try some more, but could use any big-brain knowledge.
tldr: I have been given the miracle of life, but am cheap. Plus I think one or more of these companies are misusing our funds.