Personal Liberty Poll
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.”
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