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Monday, Mar 30 2015

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Insurers Lower AIDS Drug Costs After Discrimination Charges

Aetna, and its subsidiary Coventry Health Care, will lower the cost of HIV and AIDS drugs, which can cost as much as $1,500 a month now, under insurance plans sold on the exchanges. Patient advocate groups had argued the high prices violated the health law's prohibition against insurers denying coverage to sick people or charging them more.

Coventry Health Care is lowering the cost of HIV and AIDS drugs after the insurer's prices 鈥 more than $1,000 per month on some plans sold in Illinois 鈥 drew complaints of discrimination from patient advocates. Advocates have said Coventry and other insurance companies set the costs high to deter HIV and AIDS patients from signing up for their plans, skirting a federal requirement that insurers offer coverage to anyone no matter how sick he or she is. (Venteicher, 3/27)

On Friday, Aetna, which owns Coventry Health Care of Florida, announced it would become the second company to offer reduced co-pays on all oral HIV/AIDS medications, following a civil rights complaint filed last year that accused the company and several others of discrimination. ... Co-pays 鈥 the portion of the charge that consumers pay 鈥 will now range from $5 to $100, Poole said. Before the recent price cuts by Coventry and other insurance plans, co-pays on some plans could be as high as $1,500. (Herrera, 3/27)

Aetna has changed how HIV drugs are listed within health plans sold on the exchanges after consumer groups criticized the health insurer's policy as discriminatory. Many plans on the Affordable Care Act exchanges have been found to engage in 鈥渁dverse tiering.鈥 Although the ACA prohibits health insurers from denying care to someone with a pre-existing medical condition, some companies have crafted health-benefit designs that would deter sicker people from choosing the plans by imposing higher out-of-pocket costs. (Herman, 3/27)

This is part of the Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.
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