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Very Hard To Find What Drugs Are Covered By O-Care

From a soft pedaling Associated Press:

Report: Health exchanges’ drug coverage confusing

By CARLA K. JOHNSON | April 28, 2014

CHICAGO (AP) — The hunt for a health plan that would cover a particular drug or a favorite doctor proved particularly frustrating for many consumers navigating the new insurance exchanges under the federal government’s health care overhaul, according to a report released Monday.

In nearly half the 85 health plans analyzed, it was difficult or impossible for people to determine what drugs were covered, according to the report by market research firm Avalere Health, the first systematic analysis of consumer experience on the exchanges.

Ha! Just try finding a doctor who can even prescribe the drug you need.

The report analyzed health plans in five states that relied on the federal HealthCare.gov website, as well as state-run exchange plans in Washington, D.C., and a dozen states. A directory of doctors was somewhat easier to find, but there were still some cases in which it was a very demanding search, the report found…

The  doctor directories are laughably inaccurate. When you call their offices, the vast majority of the doctors who are listed in an Obama-Care network say they are either not in the network or they are not taking new patients with Obama-Care.

What’s more, the websites typically ranked plans by premium price, which could have misled patients who needed a specific costly medication if it wasn’t covered by the cheapest plan, Avalere spokeswoman Caroline Pearson said.

"It was very difficult for consumers to get a more nuanced view of what their plans covered," Pearson said. In some cases, a consumer would have to click six times to find drug coverage information. Even worse, no links to lists of covered drugs existed for some health plans…

Most of the plans don’t even provide lists for doctors. So good luck finding which medications they cover, no matter how many times you click.

On top of that, the names of the plans don’t match the names of the private plans, so it is next to impossible to find out the information outside of the exchanges.

The situation should improve soon, Pearson said, noting the government will require plans on the federal exchange for 2015 to have direct links to lists of covered drugs, also known as formularies.

Why wasn’t that done from the start? But, sure, it’s all going to be fixed. Any year now.

This article was posted by Steve Gilbert on Tuesday, April 29th, 2014. Comments are currently closed.

One Response to “Very Hard To Find What Drugs Are Covered By O-Care”

  1. Join the Party, comrade. No pharmaceuticals for you until you do.




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