You’ve been prescribed your medications for specific reasons. These medications have been identified as helpful in treating your condition. They’re the ones most likely to help you maintain a healthy lifestyle and a good quality of life and, a few months into taking these medications, it’s been proven they work and you’re feeling better.
Finding a medication that works for your body requires a great partnership between doctor and patient. Together, they evaluate the patient’s health, symptoms and concerns, and find the appropriate medication, often testing more than one before landing on a preferred prescription. They then work together to ensure the patient takes the medication as prescribed, following all instructions with regard to dosage, time of day, frequency and other recommendations.
Everything’s working. And you’re feeling better.
But what if your health care plan’s benefits change mid-year? Right now, insurance companies with plans in the New York State of Health Exchange are able to make changes to their formularies (drug lists) in the middle of the coverage year. Mid-year formulary changes can reduce and/or eliminate access to particular prescriptions you rely upon, causing both emotional and financial consequences for the patient who no longer has the medication they need.
When a negative mid-year formulary change occurs, patients and doctors are left scrambling to find alternative medications. These can lead to a number of negative physical consequences, including:
When medical treatment is interrupted or changed, the condition being treated may worsen. For instance, an individual may be more responsive to their previous anti-seizure medication, and find themselves dealing with a reoccurrence of the health issues they’d been fighting. This worsening of health conditions may be only temporary, but it can lead to more trips to the doctor or hospital, as well as time out of work.
If you are on medication to treat a medical condition, consider your original search for an effective treatment. It may have required some trial and error to arrive at the medication that worked for your body and best treats your condition. Repeating that process again now, with your preferred medication no longer accessible, may take longer and/or lead to less favorable outcome or instability in your health.
There are also instances where the new medication prescribed may simply be less effective, even after the patient has been taking it for a few weeks. A less effective medication will lower the patient’s quality of life, allow the effects of their health condition to re-emerge or worsen, and ultimately lead to more time spent feeling unwell and/or out of work.
When trying new medications, there’s always a chance that your body reacts differently to one drug than another. These side effects of medications, such as headache, nausea or weight gain, can range in severity and, in rare circumstances, require additional medications to mitigate.
Right now, you can help New York Health Works protect millions of NYS residents who purchase their healthcare coverage through the New York State of Health exchange. Help us pass legislation, S. 5382 and A. 7707, that amends insurance law to ensure that health plans will continue coverage for necessary prescription medications during the course of the enrollment year.
Learn more, and make your opinion heard. Contact your legislators today! http://nyhealthworks.com/access/