Consumers are increasingly confronting a problem: The prescription drug benefits they need are not guaranteed if they switch health plans. This can mean trouble for a patient already on a prescription that works for them.
When a patient must switch health plans, their need for the medications they are taking doesn’t change. Their new insurance coverage, however, might through utilization review mechanisms— such as prior-authorization and denials. This can be especially harmful for those living with diabetes, heart disease, cancer, epilepsy, multiple sclerosis, HIV/AIDS, mental illness, and other serious conditions.