Healthcare Payer News: AIDS and HIV patients get limited access to drugs on Marketplace silver plans, study says

Healthcare Payer News: AIDS and HIV patients get limited access to drugs on Marketplace silver plans, study says

By Kaiser Health News

In 31 states and the District of Columbia, silver-level plans cover fewer than seven of the 10 most common drug treatment options or charge consumers more than $200 a month in cost sharing, according to an analysis of 2015 silver plans by consultant group Avalere Health.

In most states, consumers with HIV or AIDS who buy silver-level plans on the insurance marketplaces find limited coverage of common drug regimens they may need and high out-of-pocket costs, according to a new analysis.

Last year, The AIDS Institute and the National Health Law Program filed a complaint with the Office for Civil Rights of the federal Department of Health and Human Services charging that four Florida insurers — CoventryOne (which is owned by Aetna), Cigna, Humana and Preferred Medical — were violating the anti-discrimination provisions of the health law by structuring their prescription drug plans so that they discouraged people with HIV/AIDS from applying. The four insurers placed all HIV medications, including generics, on the highest cost-sharing tiers, the groups alleged. Read the full article here. »

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