Health Plans Get Very Poor Scores for Access to Autoimmune Drugs

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Three out of four insurance plans use policies that result in significant to severe restriction of access to medications for seven autoimmune diseases, according to the analysis.

"Choice among health plans is a hallmark of the American health insurance system, yet this analysis shows that people living with autoimmune conditions have few, if any, coverage choices that do not involve significant to severe access restrictions," the authors wrote.

Nearly nine in 10 Medicare plans received a C or worse for coverage of medication received via mail order or the pharmacy. In commercial plans, the majority of plans scored Cs or Fs for six of the seven conditions, excluding lupus nephritis, where 67% of all commercial health plans scored a B for access to these medications.

 

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