Copay Mechanisms: Which Card is Right for Your Product?
By Lash Group |
Traditional copay cards and programs are effective for underinsured patients. These cards often act as secondary or tertiary payments for medication and cover a portion of a patient’s out-of-pocket expense, which may vary depending on the level of coverage a manufacturer provides.
Our most flexible mechanism, the Lash Group FlexConnect card is a physical or virtual electronic benefit card that leverages seamless systems-integrated claims adjudication technology for providers, billing entities, retail or specialty pharmacies, or via online coupons and vouchers. FlexConnect harnesses the power of Lash Group technology while also ensuring that your program meets patients’ high-touch or high-automation needs. It is best suited for:
- Access to specialty drugs
- Seamless integration of services
- Managing medical and pharmacy benefits
- Leveraging eservices and scalable technology solutions
- Inserting value into providers’ existing processes
- Flexible program design
Co-pay cards that are either pre-loaded with a variable amount for use at a pharmacy or physician’s office or retroactively loaded following documentation review are also effective for covering the portion of the patient’s out-of-pocket expense that insurance will not cover. With debit cards, manufacturers can limit use to certain pharmacies or physicians.
The Lash Group FlexDebit card, our answer to the debit mechanism, is ideal when:
- A provider base does not want to buy and bill for a product
- A manufacturer wishes to provide patients with direct access to funds at the point of sale in a provider’s office
These types of cards allow patients to receive product at no cost for the initial fill. This approach is also ideal for giving patients access to a product while awaiting insurance coverage determination.
Designed for seamless access to the initial fill, our FlexStarter card can be used in combination with FlexConnect if manufacturers want to get patients on a drug quickly and then require business rules so that patients aren’t receiving entirely free copay assistance for the duration of their eligibility cycle. FlexConnect is best for:
- Faster therapy initiation
- Adjudication at the pharmacy
- Offering multiple cards within a program
- Programs that also verify financial need
- Customizing the benefit at the program level