Insurance on ACA exchanges and UC drugs

Those of you with insurance purchased through the market place for your state - have you had big difficulties getting the drugs that you need?

On the Healthcare.gov website there is a list of where you can get personal help in your area with picking the best plan for you. I was on ACA earlier this year when I was out of work. I made an appointment with one of the "helpers" and he helped me pick the best plan for prescription drugs that I could afford. Take the list of your meds and what your anticipated other medical expenses are to your appointment. If you can project what your income will be, the helper will be able to factor in any subsidies your could qualify for so you know approx. what your premiums will be.

Good luck!

The ACA policies vary a lot in the allowed doctors, facilities, and medications included within their formularies. So, it's really hard to compare. Generally, they're trying to keep costs down by limiting choices. So, you might have less to choose from.

Thanks. I was curious to see what others were experiencing. A few weeks ago I flared for the first time being on my new plan and subsequently found out that my insurance broker had not checked the formulary list for my plan to find out if my drugs were on it as I had asked. I had to go through a ridiculous pre auth process that took almost 2 weeks with the screw ups to get a simple, first line, best practice generic mesalamine enema and I was shocked. After some research and speaking with compliance officers with the state etc. I am seeing their goal of discouraging those with chronic diseases from enrolling. I looked at the formularies for all the plans available to me and NOT A SINGLE ONE, includes cortenema and mesalamine enemas!! These are standard clinical practice drugs. I am so angry! It is like they are saying they will not treat my disease! After jumping through hoops they did authorize a mere 6 weeks of mesalamine enemas. Which is a good thing or I would have filed complaints complaints complaints! I will switch insurers during open enrollment but I must admit to feeling a little scared about my options.

Have other had problems getting enemas?

hateuc. Which State are you in? I think maybe some are better than others. I am in New Mexico and ours seems to be terrible. It is really quite worrisome.

Thx hateuc. New Mexico is a poor state. Unfortunately, this may mean that insurance companies are better able to get away with offering poorer plans - less resistance from a population that is less educated and less system savvy etc.? Less state money for insurance oversight etc.?

I may need to consider actually changing jobs so I can get group coverage? Crazy.