Not long ago, Jan was feeling a lot of stress and worry over being able to pay for her medications. She was meant to take three prescriptions regularly, but the cost was more than she could afford even with her insurance plan. Knowing she couldn’t continue to pay the overwhelming out-of-pocket costs until she hit her deductible, she reached out to Athos for guidance.
“I was going to have to stop taking one of my medications because I couldn’t afford it. This thought left me scared about what it would do to my health, but I felt like there was no alternative.”
Many people benefit from lower premiums on high deductible plans; but the downside is glaring in situations like these... Jan simply could not afford to pay full price for her meds until she hit her out-of-pocket maximum. The good news? There are actually many ways to lower the out-of-pocket costs for prescriptions, and with the help of her Athos Advocate Jan pieced together two money-saving strategies and can continue taking her necessary medicine.
Her gratitude was immense—she was finally able to relax about her health, plus the fancy footwork and diligence of her Advocate will save her more than $8,000 per year!
“Athos took a giant burden off my shoulders; the financial savings were life altering”
The truth is Jan was already being as diligent as she could to solve this problem on her own—she drove 20 miles each way from her small town to her doctor's office to get samples of one particularly expensive medication she needed. Her Athos Advocate was able to create a more sustainable solution for her, signing her up for co-pay cards for two medications and applying for a patient assistance program directly with the drug manufacturer for the last which circumvents insurance completely and ended up saving her husband's employer almost $4,000 per year on top of her personal savings.
It’s worth acknowledging that these solutions are things individuals can do themselves (if they know about them!) and often they are easy to complete. But Jan’s case shows that the work doesn’t always end with signing up for a handy co-pay card—she ran into multiple issues trying to use her card because of errors in the system at her pharmacy, and without her advocates knowledge on the rules and common misconceptions about how the discount works she may not have been able to solve the problem.
“My advocate really fought for me. When my pharmacy didn’t honor the card, he kept calling them until they got it right.”
Athos advocates have an extensive knowledge of the types of programs available to help cut prescription costs and know how to navigate the system to make it actually work for the people it’s designed to help. This saves an enormous amount of time for even the most capable individuals that might spend hours learning the constantly changing rules, filling out forms, making follow up calls etc. to advocate for themselves. Athos was founded on the belief that healthcare should be a benefit and not an extra stress. And our advocates fight not only to save our members money, but valuable time that should be spent on living a healthy, happy life.
Imagine needing emergency surgery at an in-network facility, only for insurance to deny your claim.
Read MoreNot long ago, Jan was feeling a lot of stress and worry over being able to pay for her medications. She was meant to take three prescriptions regularly, but the cost...
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