The ACA, Affordable Care Act, is one that most Americans have been talking about for the past 3+years. Some of us have said that it's not Affordable and Obama doesn't Care. One thing congress did get right is that anyone with pre-existing condition can NOT get turned down for any insurance plan. One thing congress did wrong, is that it's NOT affordable to all families.
Prescriptions can fall on a specialty tier where you're not required to pay a deducible of $5, $10, or even $20 anymore. The prescriptions will now fall under a percentage of 20%, 30% or even 40% of the actual cost. Because of this specialty tier, this will make it impossible for a lot of chronically ill patients to pay for their medication and it will result in the chronically ill to withdraw from taking their medication. These individuals will result in becoming more ill and they'll end up in the hospital which will result in the insurance company to pay more. It sounds like a round about way for the insurance to pay more for their own mistake in hind sight. In the mean time it's the patient who is suffering.
The ACA or ObamaCare/Medicaid has a rule that states you can only have a maximum of 4 monthly prescriptions. If you're chronically ill this seems impossible to abide by. If you're anything like me, this will NOT work as I have 9 prescriptions monthly!
When you need the 5th prescription refilled you must contact your doctors office. The doctors office in turn must contact the HHS (Health & Human Services) and request a pre-authorization to override the amount of monthly prescriptions the particular patient can have. This must be done with each and every prescription after the 4th, 5th, 6th, and so one; every month.
The doctors offices doesn't have time to do this every month for all of the patients. According to the nurse at my doctors office, it can take them over an hour for all of the patients. This is too time consuming for the nurses. Not too mention this can hold up the patients from getting their much needed medication because you have to wait for the approval from the state. Again, the state is stepping in and controlling the patients rights.
Bottom line is that the ACA has some good features yet it has a lot of bad features that need some tweaking.
Prescriptions can fall on a specialty tier where you're not required to pay a deducible of $5, $10, or even $20 anymore. The prescriptions will now fall under a percentage of 20%, 30% or even 40% of the actual cost. Because of this specialty tier, this will make it impossible for a lot of chronically ill patients to pay for their medication and it will result in the chronically ill to withdraw from taking their medication. These individuals will result in becoming more ill and they'll end up in the hospital which will result in the insurance company to pay more. It sounds like a round about way for the insurance to pay more for their own mistake in hind sight. In the mean time it's the patient who is suffering.
The ACA or ObamaCare/Medicaid has a rule that states you can only have a maximum of 4 monthly prescriptions. If you're chronically ill this seems impossible to abide by. If you're anything like me, this will NOT work as I have 9 prescriptions monthly!
When you need the 5th prescription refilled you must contact your doctors office. The doctors office in turn must contact the HHS (Health & Human Services) and request a pre-authorization to override the amount of monthly prescriptions the particular patient can have. This must be done with each and every prescription after the 4th, 5th, 6th, and so one; every month.
The doctors offices doesn't have time to do this every month for all of the patients. According to the nurse at my doctors office, it can take them over an hour for all of the patients. This is too time consuming for the nurses. Not too mention this can hold up the patients from getting their much needed medication because you have to wait for the approval from the state. Again, the state is stepping in and controlling the patients rights.
Bottom line is that the ACA has some good features yet it has a lot of bad features that need some tweaking.
No comments:
Post a Comment