Patients with Pre-Existing Conditions May Face Higher Drug Costs

The Affordable Care Act aims to help those with pre-existing conditions get affordable medical coverage. However, some doctors claim that this is not the case. It has recently been noted that patients with serious pre-existing conditions like lupus or multiple sclerosis may not be able to get the health coverage they need to pay for their medications through the current exchange.

The primary issue is that many of the medications for serious pre-existing conditions do not have generic versions. This means that these patients will be forced to pay the full cost for their prescriptions (some bills may be upwards of $62,000).

Dr. Scott Gottlieb of the American Enterprise Institute explains,”if the medicine that you need isn’t on that list, it’s not covered at all. You have to pay completely out of pocket to get that medicine, and the money you spend doesn’t count against your deductible, and it doesn’t count against your out of pocket limits, so you’re basically on your own.”

Furthermore, doctors worry that this may cause patients to skip doses of their medication so they won’t have to refill the prescription as fast since they can’t afford the out of pocket costs. The government argues that Obamacare was attempting to resolve these issues but ran out of time before the exchanges went live. The government claims that they will continue to look into these issues and do their best to lower the cost if these prescriptions for Americans.

However, if the prescription cost is lowered, this could mean higher premium costs for individuals enrolled in the exchange. If you have any questions about what this could mean for you, please give us a call.