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Re: jmkobers post# 11581

Friday, 04/04/2014 6:06:45 PM

Friday, April 04, 2014 6:06:45 PM

Post# of 20689
Now I am confused. If they maxed out on out of pocket costs, they may wish to switch to thrice weekly as it eliminates 4 injections a week ( a convenience factor ) all the while not increasing the individual's cost as it would be covered at 100%.

The maximum out of pocket resets annually, so if generic Copaxone becomes a Tier 2 drug, current maximum out of pocket for drug costs in this plan is around $2500; however, if it were on the third Tier, presently none of the cost is applied to out of pocket maximum and next year, theoretically if there were no other medical costs (including other pharm costs) the total maximum out of pocket costs for all health care related charges is somewhere in that $12000-$14000 range (for a family I believe).

Note that I just reread your note and perhaps they will not switch to thrice weekly simply because they are now conditioned and would have to switch back the next year anyway; however, I am not certain the majority of people think that far ahead. They may still go with the perceived convenience factor.