Copayments and co-insurance fees have increased on average 34% compared with those of the pre-Affordable Care Act individual insurance market, according to the results of a new HealthPocket study released Thursday.
The study, an examination of health plans in 46 states, found consumer costs for prescription drugs have increased under all four new health plan categories created by the ACA. Consumers covered under bronze health insurance plans have seen the highest increase, 58%, while those enrolled in platinum plans see the lowest increase at 15%.
The study also found plan enrollees who use brand name drugs and specialty drugs face the greatest burden from the increases in copayments and co-insurance fees. Consumers who use medications infrequently, however, are not likely to notice the cost-sharing increases.
The 34% increase in copayments and co-insurance fees does not mean that consumers will spend 34% more on drugs, however, HealthPockets says. Drug spending is also affected by multiple factors, including deductible amounts, out-of-pocket caps and what drugs are included within a health plan's list of covered medications.
Further, before the ACA was enacted, nearly one-out-of-five health insurance plans purchased privately by individuals and families had no prescription drug coverage, leaving the full cost of prescription drugs up to the consumer.
Under the ACA, all new health plans in the individual market include a drug benefit. In addition, some over-the-counter drugs such as aspirin, folic acid and iron supplements can be obtained without any out-of-pocket cost when used as preventive medicine.
"With copayments and co-insurance fees rising, consumers must shop health plans more carefully. Copayments, deductible amounts, and limits on annual drug spending should not be ignored," saidKev Coleman, head of research and data at HealthPocket."Consumers can also discuss with their doctors whether there are alternative drugs that have lower costs but equivalent therapeutic results."
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