My wife will get her meds

[Ms. Toad]

346. Formularies are not new.

And anyone on MS meds should know that.

And anyone with MS would have been denied coverage entirely before the ACA - that means nothing would have been covered. Break an arm? Out of luck - no insurance because you had MS and couldn't be covered. Need a heart transplant? Out of luck - no insurance because you had MS and couldn't be covered. Have a baby? Out of luck - no insurance because you had MS and couldn't be covered. Need MS care other than the particular medicine in question? Out of luck - no insurance because you had MS and couldn't be covered.

Get the point? Pre-existing conditions meant zero coverage for any condition - regardless of whether it was related to the pre-existing condition or not. The ACA banned that practice - and now insurance is available including for treatment of the pre-existing condition. I suspect even the particular drug in question is covered by going through the proper procedure. From what has been described in the other threads, it doesn't look to me as if it was.

And, back to the formulary question - that is how prescription coverage has been managed for at least a decade now. Obtaining medication not on the formulary has NOTHING to do with the ACA.

That doesn't mean it is ideal - but it is orders of magnitude better than what we had before the ACA.