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KamaAina

(78,249 posts)
Thu Sep 18, 2014, 01:47 PM Sep 2014

The New Way Insurers Are Shifting Costs To The Sick [View all]

http://talkingpointsmemo.com/news/insurers-pay-more-drug-conditions

Health insurance companies are no longer allowed to turn away patients because of their pre-existing conditions or charge them more because of those conditions. But some health policy experts say insurers may be doing so in a more subtle way: by forcing people with a variety of illnesses — including Parkinson's disease, diabetes and epilepsy — to pay more for their drugs.

Insurers have long tried to steer their members away from more expensive brand name drugs, labeling them as "non-preferred" and charging higher co-payments. But according to an editorial published Wednesday in the American Journal of Managed Care, several prominent health plans have taken it a step further, applying that same concept even to generic drugs.

The Affordable Care Act bans insurance companies from discriminating against patients with health problems, but that hasn't stopped them from seeking new and creative ways to shift costs to consumers. In the process, the plans effectively may be rendering a variety of ailments "non-preferred," according to the editorial.

"It is sometimes argued that patients should have 'skin in the game' to motivate them to become more prudent consumers," the editorial says. "One must ask, however, what sort of consumer behavior is encouraged when all generic medicines for particular diseases are 'non-preferred' and subject to higher co-pays."


Derp.
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+1,000! They also require you to get your prescriptions from their mail order pharmacies, no retail. Dustlawyer Sep 2014 #1
I hear you. I get so frustrated when I am in line at a pharmacy, and they truedelphi Sep 2014 #8
+1 Enthusiast Sep 2014 #16
I fired my local pain management doctor for lying to me (usually it's the other way around). Dustlawyer Sep 2014 #20
I have been on Medicare and Plan D for years now. This is not new. They have always told us when jwirr Sep 2014 #25
I Don't Doubt People Have Problems With Mail Order Scripts... ChiciB1 Sep 2014 #22
And they can change the tiers at any time, but you're locked into them for a year. SharonAnn Sep 2014 #2
Is anyone shocked by this? dilby Sep 2014 #3
^^^^^^^^^^^^^^^^^^^^^^^^n/t truedelphi Sep 2014 #9
+1 You nailed it. Enthusiast Sep 2014 #15
+1 leftstreet Sep 2014 #24
So get to work. jeff47 Sep 2014 #26
Right on! Louisiana1976 Sep 2014 #29
my plan has 3 tier co-pay pricing for meds: $15/30/40. guess how much i pay for zomig? unblock Sep 2014 #4
Yeah, they are also working overtime to deny claims. NYC_SKP Sep 2014 #5
Anthem. Say no more. KamaAina Sep 2014 #6
+1 Enthusiast Sep 2014 #14
Were you there with us early on, when we activists all pointed out how this truedelphi Sep 2014 #11
Well, saved my friends life, pre existing condition wise. AND... NYC_SKP Sep 2014 #30
Who could have possibly known????????????????? BrotherIvan Sep 2014 #7
Looks like the law is going to have to change ... aggiesal Sep 2014 #10
kick rec. Doctor_J Sep 2014 #12
I have an answer for that. Enthusiast Sep 2014 #13
And by doubling the copays Dont call me Shirley Sep 2014 #17
As long as significant portions of the health care payment system remain Jackpine Radical Sep 2014 #18
How STUPID can they get?? moonbeam23 Sep 2014 #19
The fact that patients are thought of as "consumers" instead of "sick people" tells you everything. RedSpartan Sep 2014 #21
Anyone here use Advair? Nye Bevan Sep 2014 #23
Health care should cost money, not make it. Spitfire of ATJ Sep 2014 #27
The biggest mistake in forming a national health plan is including Cleita Sep 2014 #28
Snobs will always choose the most expensive... quadrature Sep 2014 #31
Huh? KamaAina Sep 2014 #32
suppose there is a generic drug ... quadrature Sep 2014 #33
But these insurance co's are blacklisting the generic drug, too. KamaAina Sep 2014 #34
you have a good point quadrature Sep 2014 #35
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