One-third of US adults say their healthcare plan doesn’t cover drugs they need

While most of Americans’ health insurance plans cover prescription drugs, more than a third of adults say that in the last year, they or someone in their home has been told their plan wouldn’t cover a drug prescribed to them, according to a poll cited by NPR.

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Of those people, nearly half  said if their insurance didn’t cover a drug, they just didn’t fill the prescription, according to a poll released by NPR, the Robert Wood Johnson Foundation and the Harvard T.H. Chan School of Public Health.

The survey included 1,885 adults living in the U.S. 

The choice to not fill a prescription was found to be most common among lower-income adults, with 49 percent saying they’ve avoided filling a prescription after being told their insurance wouldn’t cover it. 

Among the highest-income population, 41 percent said they’ve avoided filling a prescription when denied coverage, and 32 percent of middle-income adults said they’ve done the same, NPR reported. 

Among people who make over $500,000 a year, 18 percent said they still did not fill their prescription when denied coverage even if they could afford to. 

Insurers deny a specific prescription typically either to request more information from the prescribing physician or to recommend a different drug, Cathryn Donaldson, director of communications for America’s Health Insurance Plans told NPR. She added that denials can be appealed and overturned. 

But patients may not know they are allowed to appeal or have the ability to appeal denials from their insurance company, Frederick Isasi, director of the consumer advocacy group Families USA told NPR

“If insurance companies were actually focused on getting the right treatment to patients, they’d facilitate a conversation with patients and providers and work together to find the best treatment, not simply send a denial,” Mr. Isasi said. 

Read the full article here

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