"Obamacare plans bring hefty fees for certain drugs"

[applegrove]

Obamacare plans bring hefty fees for certain drugs

By KELLI KENNEDY
Associated Press

http://hosted.ap.org/dynamic/stories/U/US_HEALTH_OVERHAUL_PRESCRIPTION_COSTS?SITE=AP&SECTION=HOME&TEMPLATE=DEFAULT

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Mason is one of the many Americans with serious illnesses - including cancer, multiple sclerosis and rheumatoid arthritis - who are indeed finding relatively low monthly premiums under President Barack Obama's law. But some have been shocked at how much their prescriptions are costing as insurers are sorting drug prices into a complex tier system and in some cases charging co-insurance rates as high as 50 percent. That can leave patients on the hook for thousands.

"I was grateful for the Affordable Care Act because it didn't turn me down but ... it's like where's the affordable on this one," said Mason, a 61-year-old from West Lafayette, Indiana who currently pays an $800 monthly premium.

Before the federal health law took effect, Mason paid slightly more for her monthly premium on a plan that didn't cover her arthritis or pain medications and some routine doctor's visits.

Avalere Health, a market research and consulting firm, estimates some consumers will pay half the cost of their specialty drugs under health overhaul-related plans, while customers in the private market typically pay no more than a third. Patient advocates worry that insurers may be trying to discourage chronically ill patients from enrolling by putting high cost drugs onto specialty tiers.




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[applegrove]

1. We have public health care in Canada. There is catastrophic help for meds

in Ontario. And disability covers drugs. But lots of people have to pay out of pocket for their meds.

[pnwmom]

3. Thanks for the info. I've also read that the coverage varies widely from province to province. n/t

[applegrove]

5. Absolutely.

[SheilaT]

2. Once again the problem is with the insurance companies

and the drug companies.

[pnwmom]

4. Mostly with the drug companies, IMHO. Even Medicare, Medicaid,

and other countries' national health systems have drug formularies listing the drugs they will pay for.

[napi21]

6. All of the plans I checked had a max out of pocket amount each year.

I reviewed plans for my cousin from PGH, Pa. She dabbles a bit with a computer, but was scared to pick out a plan that suited her. The crappy ins. plan she had was through the State of Pa. Not Medicaid, but for lower income people . She was paying $239/mo. for really crappy ins. It didn't cover any drugs, she was only allowed 3 doctor visits per quarter, and there was a cap of $12,000 per year. She had a previous condition, and her only income was SS widow's benefits.

All the plans I looked at included prescription drug coverage with 3 tiers, $5/$20/$45. For specialty drugs, the ins. paid 80%. There was no limit on doctor visits, and co-pays of $20 for a GP, $35 for a specialist. Also had an annual deductible of $300 AND a maximum out of pocket liability of $3,500. If you reached that max, there were no more co-pays on anything. Her final cost ended up being $76.00/mo.

I don't understand what the woman you referenced is complaining about. Sure everyone would like the drugs to be free, but her old policy didn't cover ANY drugs. AT least now some of the drugs are covered. She might also check with her doctors to see if there is some other drug formulary that would be covered. I am on Medicare and have a supplement plan & a plan that covers drugs. I was prescribed a drug for osteoporosis. It cost me $89.00 (which was my co-pay!). I called the Dr. and asked if there was another drug that would do the same thing and she prescribed one that reduced my co-pay $6.00.