Obamacare Plans Milk Deductibles For All They’re (Not) Worth

Drugs and Money

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If you’re unfortunate enough to be attached to a health plan that has revised its prescription drug co-pay policy under Obamacare, expect to pay out of pocket for all of your medications until you’ve spent enough money to meet your annual deductible.

According to a report last week by health policy research company Breakaway Policy, in conjunction with the Robert Wood Johnson Foundation, while prescription drug co-payments may be incorporated into an Obamacare plan, they are virtually meaningless for most patients because they don’t kick in until the patient has paid out of pocket for medications up to their annual deductible.

The out-of-pocket requirement applies to policies crafted around “combined deductible” plans, which make up half of the middle-tier “silver” Obamacare plans the study examined:

Of the 1,208 unique Silver plans analyzed, approximately half (641) offer combined deductibles under which medical and prescription drug expenses accumulate to a single deductible. The average combined deductible for those plans is $2,267 for a 27 year-old individual. The other approximately half of plans (567) have two separate deductibles, a medical deductible towards which expenses for medical services accumulate and a drug deductible towards which expenses for prescription drugs accumulate.

Obamacare customers in that first group will have to pay every penny of their prescription costs out of pocket before their co-pay kicks in — all while paying monthly premiums.

Obamacare has already been blasted for driving up deductibles — a fact that only exacerbates the out-of-pocket drug mandate.

That means hefty out-of-pocket expenses for Obamacare plan holders, especially since Obamacare deductibles are “relatively high” as compared to employer-sponsored insurance plans.

“In addition to being relatively high as compared to the ESI [Employer-sponsored insurance] market, deductibles under [Obamacare] Exchange plans are being applied to products and services not generally subject to the deductible in ESI plans, such as prescription drugs and physician visits,” the study concludes. “This could further complicate enrollees’ task of evaluating plans’ cost sharing provisions, as they will not only have to consider the amount of deductibles but also the way they are applied.”

Note from the Editor: As you’ve just read, the Obamacare abomination doesn’t bode well for anyone. But if you know how to navigate the system you can still control your own healthcare—as every American should! My trusted friend and medical insider, Dr. Michael Cutler, and I have written a concise guide to help you do just that. I urge you… Click here for your free copy.

Personal Liberty

Ben Bullard

Reconciling the concept of individual sovereignty with conscientious participation in the modern American political process is a continuing preoccupation for staff writer Ben Bullard. A former community newspaper writer, Bullard has closely observed the manner in which well-meaning small-town politicians and policy makers often accept, unthinkingly, their increasingly marginal role in shaping the quality of their own lives, as well as those of the people whom they serve. He argues that American public policy is plagued by inscrutable and corrupt motives on a national scale, a fundamental problem which individuals, families and communities must strive to solve. This, he argues, can be achieved only as Americans rediscover the principal role each citizen plays in enriching the welfare of our Republic.

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