Access to prescription medicines is critical to help patients manage their chronic conditions and maximize quality of life. Unfortunately, even with insurance coverage, many patients still struggle to get the medicines they need due to high out-of-pocket costs and other plan restrictions. We looked at the burden on patients with health insurance exchange coverage in 2014 and 2015. Now, we’re taking a look at 2016 coverage.
A new analysis by Avalere Health offers data on access to medications for chronic conditions in exchange plans in 2016. For many, as highlighted in earlier research, health insurance exchange plans may cover a medicine, but place it on the highest cost-sharing tier. When the medicine a patient needs – brand or generic – is on a high cost-sharing tier with no alternative on a lower cost-sharing tier, patients are faced with tough choices. This is one reason why more needs to be done to engage and empower patients and stop practices that may discriminate against patients with certain chronic conditions.
Here’s how 2016 health insurance exchange coverage stacks up for patients with these five conditions:
Check back next week – we’ll be covering five more conditions. For more, visit AccessBetterCoverage.org.
Allyson Funk Ally is a senior director of public affairs at PhRMA focusing on Medicare, Medicaid, the Affordable Care Act, and other public programs. Her previous experience includes leading health communications for a large membership organization, supporting public affairs clients, and working for the governor of Louisiana. Ally enjoys travel, trying new restaurants and spending time with Buddy, her 9-year-old rescue Pomeranian. In the fall, she and her husband are almost always wearing Saints gear.