Medication axed by obamacare

[Katzndogz]

If you like your plan you can keep your plan.

If you like your doctor you can keep your doctor.

Now the next lie.

If you like your medication you can keep your medication.

You can IF you pay for it yourself.

Can You Even Keep or Afford Your Medicine Under Obamacare? | TheBlaze.com

“If you like your medicines, you may not be able to keep them under Obamacare,” health policy analyst Scott Gottlieb wrote in a Forbes column. “Health plans are cheapening their drug formularies – just like they cheapened their networks of doctors. That’s how their paying for the benefits that President Obama promised, everything from free contraception to a leveling of premiums between older (and typically costlier) beneficiaries, and younger consumers.”

 

[koshergrl]

You can't keep your plan, you can't keep your doctor...and you can't keep your meds.

But there are absolutely no bureaucrats determining whether or not you rate treatment!

" The President famously promised that you could keep your health plan and doctor. For many people, both of those pledges are turning out to be false. And now, you might not be able to keep your medicine, either.
There are two reasons why. The first has to do with the higher out of pocket costs patients will face. The second issue may be even more significant.
Simply put, many drugs may not be covered at all, and the costs patients incur by buying them with cash won’t count against out of pocket caps. This has repercussions for drug makers with big portfolios of specialty and primary care drugs (more on that later). But most of all, it has implications for patients.
Drugs on your health plan’s formulary will typically have fixed co-pays. These costs usually count toward your deductible and the out of pocket and lifetime limits on the total amount of money that your health plan can ask you to spend.
As the Wall Street Journal recently reported, these co-pays can already be substantial, pushing people quickly to their annual out-of-pocket limits — $6,350 for individuals and $12,700 for families (after which insurers pay the full tab)."


"People whose annual income is at or below 250% of the Federal Poverty Level will qualify for cost-sharing reductions. (That comes out to families of four earning less than about $60,000, or individuals earning less than $30,000). But people qualify for these cost-sharing subsidies only if they enroll in a higher cost, “silver” Obamacare plan.
Take, for example, the drug Copaxone for multiple sclerosis.
Someone on a bronze plan would be responsible for paying about 40% of the drug’s costs out of pocket, on average. That comes out to about $1,980 a month.
If you buy the highest cost platinum plan, the out of pocket costs drop to $792 a month. But you’re probably better off with the cheaper bronze plan anyway.
Since you’re going to hit your out of pocket cap regardless of your plan, you might as well save money on the premium (which doesn’t count against your deductible or out of pocket limits) and race to the $12,700 spending cap as quickly as your family can.
After all, the provider networks (and formularies) used by low cost “bronze” and high cost “platinum” plans are often the same. The only thing that varies between different “metal” plans is typically the co-pay structure. Why pay higher premiums just to lower your co-pays when you’re going to hit the out of pocket caps anyway.
By purchasing a costlier, gold or platinum plan, you typically can’t “buy up” to a higher benefit. What you’re really doing is just prepaying the cost sharing.
But at least — in this model case — the drug Copaxone was partially covered under the Obamacare plan’s formulary. Consider an even bigger problem lurking inside the law.
The co-pay structure, and the out of pocket caps on consumer spending only apply to costs incurred on drugs that are included on a plan’s drug formulary. This is the list of medicines that the health plans have agreed to provide some coverage for.
If the drug isn’t on this formulary list, then the patient could be responsible for its full cost (with little or no co-insurance to help offset that cost). Most of the Obamacare plans have “closed” formularies where non-formulary drugs aren’t covered. Moreover, the money consumers spend won’t count against their deductibles or out of pocket limits ($12,700 for a family, $6,350 for an individual).
These are the ways that Obamacare cheapens the health coverage in order to pay for all of its expensive mandates. Obamacare is a throwback to the old HMO model of the 1990s, which promised a broad package of coverage for primary care benefits like vaccines, and routine doctor visits. But to pay for these benefits, the Obamacare plans skimp on other things – principally the number of doctors you’ll have access to, and also, the number of costlier branded drugs that make it onto formularies.
Many Americans rejected these restrictive HMO model plans in the 1990s, in favor of PPO-style plans that had higher cost sharing for routine health services, but offered broader access to doctors and have bigger drug formularies. What Obamacare says, in effect, is that Americans made the wrong choice when they rejected those HMO plans in favor of PPOs. The President thinks the more comprehensive, but restrictive HMOs were the better choice after all."







No, You Can't Keep Your Drugs Either Under Obamacare - Forbes

 

[FA_Q2]

Not surprising – these are all cost saving measures that the insurance companies are going through because of the increased burdens they believe they are going to face. What I get a kick out of is the fact that Obama was damn sure to require birth control be provided for free but then other medications may get cut entirely let alone be provided with costs.

So, what makes birth control so much more important than life saving chemotherapy drugs? THIS IS WHY YOU DON’T PUT POLITICIANS IN CHARGE OF ANYTHING!