Comparing Employer-Sponsored And Federal Exchange Plans: Wide Variations In Cost Sharing For Prescription Drugs.
Just under seven million Americans acquired private insurance through the new health insurance exchanges, or Marketplaces, in 2014. The exchange plans are required to cover essential health benefits, including prescription drugs. However, the generosity of prescription drug coverage in the plans...
| Publicado en: | Health Affairs Vol. 34; no. 3; pp. 466 - 477 |
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| Autores principales: | , , , |
| Formato: | Journal Article |
| Publicado: |
Health Affairs Publishing, LLC
Mar2015
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=101427958&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 101427958 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 02782715 HAF jtl: Health Affairs issn: 02782715 maglogo: N pubinfo: dt: Mar2015 vid: 34 iid: 3 pid: 1453 pub: Health Affairs Publishing, LLC place: Washington, District of Columbia artinfo: ui: 101427958 103770411 10.1377/hlthaff.2014.0615 101427958 ppf: 466 ppct: 11 formats: tig: atl: Comparing Employer-Sponsored And Federal Exchange Plans: Wide Variations In Cost Sharing For Prescription Drugs. aug: au: Buttorff, Christine Andersen, Martin S. Riggs, Kevin R. Alexander, G. Caleb affil: associate policy researcher, RAND Corporation, Arlington, Virginia sug: subj: Insurance, Pharmaceutical Services Economics Insurance, Health Economics Health Insurance Exchanges Health Benefit Plans, Employee Patient Protection and Affordable Care Act Comparative Studies Data Analysis Descriptive Statistics Human Funding Source ab: Just under seven million Americans acquired private insurance through the new health insurance exchanges, or Marketplaces, in 2014. The exchange plans are required to cover essential health benefits, including prescription drugs. However, the generosity of prescription drug coverage in the plans has not been well described. Our primary objective was to examine the variability in drug coverage in the exchanges across plan types (health maintenance organization or preferred provider organization) and metal tiers (bronze, silver, gold, and platinum). Our secondary objective was to compare the exchange coverage to employersponsored coverage. Analyzing prescription drug benefit design data for the federally facilitated exchanges, we found wide variation in enrollees' out-of-pocket costs for generic, preferred brand-name, nonpreferred brand-name, and specialty drugs, not only across metal tiers but also within those tiers across plan types. Compared to employer-sponsored plans, exchange plans generally had lower premiums but provided less generous drug coverage. However, for low-income enrollees who are eligible for cost-sharing subsidies, the exchange plans may be more comparable to employer-based coverage. Policies and programs to assist consumers in matching their prescription drug needs with a plan's benefit design may improve the financial protection for the newly insured. pubtype: Academic Journal doctype: Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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