Another class of people whose medical costs are going way up because of Obamacare are folks with chronic diseases such as cancer, HIV, and multiple sclerosis. People with these and and other chronic diseases might pay more out of pocket for their medications next year. A greater share of insurance plans sold in the healthcare.gov marketplace will require consumers to pay 30% or more of the cost of specialty drugs, according to a new analysis from consultant Avalere Health.
The incidence of plans charging coinsurance greater than 30% for specialty medications has increased from 27% of Silver plans in 2014 to 41% in 2015. Coinsurance is the practice of charging consumers a percentage of the total cost of the medication, as opposed to a set co-payment fee. Approximately two-thirds of exchange enrollees picked Silver plans in 2014.
There is no consistent definition of specialty drugs. The term generally refers to medicine used to treat severe or rare illnesses. The doses can cost thousands of dollars a month. Asking patients to pay 30% of that can mean some people will simply do without their medication.
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