The Georgetown University’s Center on Health Insurance Reforms recently released an issue brief entitled “Specialty Tier Pharmacy Benefit Designs in Commercial Insurance Policies: Issues and Considerations.” A prescription drug benefit can be especially important for people with disabilities as they are considering their options in qualified health plans. This issue brief draws attention to how insurance companies have started treating prescription drugs with various tiers and what the implications are for this practice. The brief provides a history of how insurance companies began implementing a tiered policy for prescription drugs and how the practice has evolved with the introduction of newer specialty drugs. The brief also highlights legislation and/or regulations either already enacted or being considered at the state level which would address some of the inequities that occur with a tiered prescription drug benefit design.
Navigators and enrollment specialists who want to learn more can read this issue brief to understand the important issues that arise for consumers with disabilities and any other individuals who use specialty drugs. The issue brief can be accessed by clicking here. It can also be found on our Resources & Links page under “Enrollment Resources – Overview.”
