“Major changes could be coming for prescription drugs”


October 12, 2016

By Kim Passoth, ATLANTA (CBS46) –

“You could soon be paying more and getting less as major changes could be on the way for prescription drug coverage.

Many health insurance companies are changing their policies, meaning drugs currently covered by your insurance carrier may not be next year.

A battle between drug companies trying to make as much as they can and insurers trying to keep the costs of drugs down could catch consumers in the middle.

Georgia State University professor Bill Custer keeps a close eye on the healthcare industry and says all insurance companies are now reevaluating how they cover pharmaceuticals.

“We are seeing that across the board, it doesn’t matter where you get coverage. The driver of the healthcare cost increases has in large part been pharmaceutical prices,” says Custer.

Custer says as drug companies raise prices, some insurance companies will refuse to pay and brand name medications will be dropped. But a cheaper, generic equivalent should be covered.

“Most insurers are not dropping drugs for which there is not a therapeutic equivalent. They are looking out for their bottom line as a company and we are looking out for the consumer,” continued Custer.

Beth Stephens is with consumer watch dog group “Georgia Watch” and says it’s important to contact your insurance provider to find out if the drug you need will be covered in 2017.

But what if it isn’t? Stephens says you should talk to the physician who prescribed the medication and see if there is an alternate substitute. If that doesn’t work, you can file an appeal with your insurance plan.

By the way, if you do need to change plans, remember that you can only do so during the open enrollment period. That starts November 1 and continues through January.”

Copyright 2016 WGCL-TV (Meredith Corporation). All rights reserved.

Original story link can be found here.