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Friday, Nov 13 2015

Full Issue

Silver-Level Health Insurance Plans' Coverage Of HIV Drugs Limited, Study Finds

Only 16 percent of the popular plans cover all 10 of the most common drug regimens and charge less than $100 a month in consumer cost sharing, according to a report by Avalere Health. Elsewhere, Connecticut's co-op is staying in business but plans changes to sustain operations.

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. 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. Only 16 percent of those marketplace plans cover all 10 of the top HIV/AIDS drug regimens and charge less than $100 a month. (Andrews, 11/13)

Because it has no plans to shut down and is marketing health plans for 2016, Connecticut鈥檚 health insurance 鈥淐O-OP,鈥 HealthyCT, is already more successful than more than half of its counterparts across the country. But the Wallingford company still has a ways to go to achieve long-term sustainability. (Levin Becker, 11/13)

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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