Popular Health Insurance Plans Leave Patients Lacking Rx Coverage

Anyone who takes medicine knows that the cost of prescription medication is rising in this country. Roughly 23% of all global health care spending in the United States is for prescription medicine. For a lot of patients, prescriptions help them live a more productive, happier life, but only if they can afford to take them.

One of the fastest growing segments of the health insurance business in the United States is the Limited Benefit Medical Plan, or Mini-Meds. These are plans that have a scaled down benefit and premium. They usually have serious limitations compared to a major medical and are frequently marketed to businesses that have a large segment of low income workers.

One of the limitations of these plan is the prescription benefit. Frequently the “benefit” is a discount drug card. Occasionally there will be an insured benefit. If there is, it will have a monthly and/or annual maximum. For plan members that require expensive brand name medicine, these limited benefit Rx plans can leave the low income employee with a tremendous out of pocket expense and a negative perception of the value of the plan.

One option that the employer should consider for a low cost benefit that might be helpful for the employees and their families is to look for Patient Assistance Programs (PAPs). If you meet the income guidelines you will qualify for prescription drug help. Rx help is available to individuals who meet criteria set by each individual drug company. PAPs provide low-cost or free medication for those who qualify. 

Patient Assistance Programs are an overlooked resource in helping the lower income, underinsured workforce. By making prescription medication available to those that can’t afford it, health care costs resulting from non treatment of chronic conditions are better controlled and help reduce the impact of inflation on health care. In the workplace there is lower absenteeism and presenteeism and greater value perception of the benefits package.

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One Response to Popular Health Insurance Plans Leave Patients Lacking Rx Coverage

  1. Very nice information. Thanks for this.

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