Affordable Health Insurance Is Less Accessible For Expensive Drug Users

Armen Hareyan's picture
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Health insurance companies are requiring co-payments for expensive drugs for those with serious diseases, and this practice is spreading fast making affordable health insurance less accessible.

Patients suffering from serious diseases, such as multiple sclerosis, rheumatoid arthritis, hemophilia, hepatitis C, and some cancers, are facing a situation to huge amount of money for expensive medications to treat diseases.

Previously, individuals and families with health insurance were required to pay a fixed $10, $20 or $30 co-payment for all medication. These payments did not depend upon the necessary drug cost, even for expensive drugs. However, this new tendency adopted by health insurers will require patients with serious health conditions to pay hundreds and thousands of dollars for life saving drugs.

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Patients are required to pay from 20% to 33% of drug cost. This means, that some seriously ill patients will have to pay more for medications than on mortgages. The costs may even be more than actually salary. Under these new terms even insured people will face huge difficulties.

This new health insurance system is called Tier 4 and Medicare drug plan already consists of 86% Tier 4. There is also Tier 5 plan, which requires even higher co-payment for the most expensive drugs. Private health insurers also consist of 10% Tier 4.

Private insurance is mainly acquired by individuals privately or through employers. Tier 4 is being welcomed by employers who want to keep their spending down.

Insured people did not have any idea about this new health insurance requirement. They found it out during buying medications. Most of US population is not financially ready to the new Tier 4 requirement, but the number of health insurers adopting it is rapidly increasing.

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