What you should know about non-medical switching of prescription drugs

June_BlogHeaders_WhatYouShouldKnowImagine you are a patient who is taking medication for an acute, chronic, or rare medical condition. Suddenly, during the contract year and for a non-medical reason, your health plan stops covering your drug. This unjustified, potentially dangerous practice is becoming increasingly common. It is called non-medical switching, since the change rarely happens for medical reasons.

Insurance companies can, and do, stop covering drugs and they move drugs to new formulary “tiers” that result in higher out of pocket costs for patients. This practice can put the stability of a patient’s health at risk, and can be prohibitively costly to patients.

Many patients have been through years of trial and error with various therapies to find the treatment that works for them with the least amount of side effects.  Non-medical switching can result in adverse side effects, decreased treatment adherence and effectiveness.

When prescription drugs do not work or patients cannot afford their co-payments, unintended health consequences result, such as increased ER visits, hospitalizations, physician visits and lab tests – which all drive up health care costs.  Insurers decisions to deprive patients of treatments that work can be stopped, if the New York legislature passes S.5022/A.2317 before recessing this month.  You can read a related blog here:  http://nyhealthworks.com/blog/emotional-disruption-caused-when-healthcare-plan-benefits-change/


How To Prevent Non-Medical Switching in Healthcare Plans

New York State Senator Sue Serino and Assembly Member Crystal Peoples-Stokes have sponsored legislation, S. 5022 and A. 2317, that protects New York patients against non-medical switching of prescription drugs.

We need you to contact your legislator.

Together, we can make sure health insurance companies cannot take the medications you need and believed you would receive as a part of your coverage, off of their drug formularies (the list of medications they will cover in your plan) or unexpectedly switch those medications to another tier that will raise their cost for patients.

Take action today: http://nyhealthworks.com/access/