Meds, Mind, Body & Benefits > Insurance, Benefits Programs & HIV

$0 copay for UHC members (plus a story)


Last year I started a new job whose medical insurance is through UHC. Unlike the Cigna plans I've previously had, my UHC plan does not count the value of copay cards towards deductibles. Copay accumulators -- a scheme in which insurance companies essentially get paid twice, once by customers and a second time by copay cards -- have become rather common. I ordered a Juluca refill in the spring, which exhausted the card's balance. I had enough to get me through the end of the year, however.

Oh, and my doctor of 14 years suddenly and unexpectedly retired. Ugh, I hate starting over with anything. Now I've got to sort a new plan and find two new docs in the same practice -- a PCP and an IDD. Unlike the doc I had, none of the other docs in that practice is a combined PCP+IDD. In fact, I couldn't find one anywhere in Seattle. Le sigh.

Quite by accident and much to might delight I stumbled across My ScriptRewards, a UHC program that offers zero dollar copays for certain medications. Click the $0 Cost-Share HIV Program button on the web page and fill in your insurance details. You'll receive an email indicating they've started the enrollment process. In about two weeks you'll receive a reply.

Drugs in this program:

* Cimduo plus Isentress
* Cimduo plus Tivicay
* Dovato
* SymfiAfter my enrollment was complete, UHC's drug price checker indeed showed $0 for these medications! I placed an order yesterday for Cimduo and Tivicay. Shipped today.

If your coverage is a commercial group plan through UHC, check this out. No clue why they don't publicize it more. Oh, and don't bother trying to get anyone on the phone there about this program -- the folks who answer phones have no clue what it is. "For the tenth time I'm telling you this isn't manufacturer co-pay assistance! It isn't an OptumRX thing! Can't you just Google it?"

Story time

I was hoping for an easy switch to Dovato. Curiously, the new doc expressed concern because it contains only one NRTI: lamivudine. I had previously been on lamivudine-containing regimens before: Epzicom + Reyataz and then Triumeq. Dovato is Triumeq minus abacavir. Should be OK, yeah? I'm currently on a two-drug regimen, why would the other one be any different? She offered what seems like a shaky reason: treatment history and virus strain.

My treatment history has been fine: tested in 2007; VL >1,000,000; CD-4 250. After six months VL was undetectable and CD-4 shot up to 600. It's stayed there ever since, with no blips. I've never experienced a treatment failure. My various regimen changes have been purely in pursuit of convenience and lower overall drug burden.

The 2007 test revealed I'm carrying a strain with the K103N mutation. It's resistant to two NNRTIs: nevirapine and efavirenz. It isn't resistant to the ingredients in Dovato, with which I have prior good experience.

My suspicion is that she's not a fan of two-drug STRs. So it's back to three drugs, two pills per day -- for little while, at least. Perhaps in six months I might ask a different doc in the practice. They load-balance patients across six; not exactly my preference but I'll deal with it. I'd prefer to avoid tenofovir if at all possible.

How y'all doing? It's been a while since I've visited. Seems to be less activity in the forums these days. An unfortunate trend elsewhere, too: the tech and gadget forums I once frequented regularly are now mostly ghost towns. Hoping we can finally get over this damn plague soon!

thanks for this tip on my scriprewards.  just curious are you on high deductuble  with HSA or standard PPO program?  i am about to switch through work from cigna to UHC and dreading it cause they sucked compared to Cigna last time I had it.  I picked high deductible with HSA

High deductible with an HSA. HSA plans are fantastic because of their multiple tax advantages.

Looks like I'll be departing UHC at the end of this year. My employer is switching to Aetna. At first I was worried that I couldn't find a similar program. However, earlier this year Washington State passed a law that requires insurance companies to count payment assistance and coupons towards deductibles, woo hoo! I plan to switch back to Juluca and use a copay card on Jan 1st. That one 90-day fill will satisfy my deductible (which is only $3000) for the year.


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