Manufacturer Copay Cards: Everything You Need to Know - GoodRx (2024)

As prescription medication prices continue to rise, it’s no surprise that patients are looking for ways to save. When insurance isn’t enough, many people turn to manufacturer copay cards to help offset some of the costs.

These savings programs, which come directly from medication manufacturers, can help patients who are struggling to afford expensive brand-name medications. But they have also been met with criticism, as some say that they end up increasing total costs.

Here’s everything you need to know about manufacturer copay cards.

What are copay cards?

Manufacturer copay cards are a way to save on medications. They’re also called copay savings programs, copay coupons, and copay assistance cards. They help people afford expensive prescription medications by lowering their out-of-pocket costs.

Copay coupons are typically for expensive, brand-name medications that don’t have a generic equivalent. For example, you can get the brand-name arthritis medication Humira for as little as $5 per month through the manufacturer AbbVie’s savings card. And you can get Humalog, a popular insulin brand-name medication, for as little as $35 per prescription through the Lilly Diabetes Solution Center.

How do copay cards work?

The idea behind copay cards is to reduce the total out-of-pocket expense for the patient. When you use one, your health insurance pays some of the cost and then the manufacturer pays part or all of the cost that you’re responsible for through your copay or coinsurance. If your insurer doesn’t cover the medication you’re taking, the manufacturer will simply cover all or some of your costs.

How do I get a copay card?

Copay cards are usually accessed through the medication or manufacturer websites. You can also ask your healthcare provider or pharmacist about copay cards for your medications.

To sign up, register online or call the program to enroll. Once you’re enrolled, the manufacturer will usually provide a card to print out and bring with you to the pharmacy.

Are there any requirements or restrictions?

For most copay cards, there are two main requirements:

1. You must have commercial or private insurance.

2. You cannot have government health insurance, such as Medicare or Medicaid.

This is due to anti-kickback statutes that prohibit manufacturers from inducing the purchase of an item for which someone may be reimbursed by the federal government.

For many cards, there is also an expiration date and a savings maximum. It varies by medication, but there is typically a monthly or annual maximum. There are also sometimes restrictions on the maximum number of times you can use the card.

Depending on where you live, there may also be laws that restrict the use of certain copay cards. In 2017, California banned the use of coupons to purchase brand-name medications that have generic equivalents.

When signing up for a copay card, be sure to carefully read the terms and conditions. You can always call the program if you have specific questions.

Are there concerns about copay cards?

Despite the savings, critics argue that copay cards actually increase costs in the long run. They say the cards encourage people to stick to costly brand-name medications instead of taking cheaper generic versions. And, they point out, that manufacturers add costs to the healthcare system by shielding patients from expenses and raising prices for insurers.

Pharmacy benefit managers and insurers have started to combat the use of copay cards. Some refuse to count them toward deductibles or out-of-pocket maximums in an effort to shift the costs back onto patients.

Copay cards don’t always provide enough help, either. Patients sometimes resort to calling manufacturers and asking for direct reimbursem*nt.

How do I know if a copay card is available for my medication?

GoodRx has the largest database of copay cards, which includes more than 700 medications. To find one, search the name of the medication on goodrx.com and scroll down to “Ways to Save” to see if there is a copay card available.