Friday, September 20, 2013

Patients Don't Know What Drugs will be Offered in ObamaCare Exchanges and as Many as 45% of Drugs Won't be Covered

Among the most troubling questions facing consumers as they shop for insurance under the Obama administration’s new health care law is whether the plans will cover the drugs they take — and how much they will have to pay for them. 
But with less than two weeks remaining until enrollment opens on Oct. 1, the answers are still elusive and anxiety is growing for consumers whose well-being depends on expensive medications. 
States running the marketplaces where the plans will be offered have not released details about which drugs will be covered. Insurers have said little about how much consumers will be asked to contribute or what types of restrictions will be placed on certain medicines. Of the few states that have revealed specifics, some have plans that will require patients to contribute as much as 50 percent of the cost of the most expensive drugs. ... 
The plans offered in the marketplaces must cover a minimum number of drugs in every treatment category, with the exact count set by a representative commercial plan, known as a benchmark plan, that is designated in each state. 
Oregon, Virginia, Connecticut and other states plan to cover more than 97 percent of drugs, while others like Maryland, Colorado and California plan to cover 54 to 84 percent, according to an analysis by Avalere Health, a consulting firm. Patients can lobby for an exception if they can demonstrate that a drug not covered by their plan is medically necessary. ...