Category: Insurance

clipboard with health insurance on it

As drug makers are facing increasing scrutiny over high drug prices, pharmacy benefit manager (PBM) Express Scripts announces that they will be excluding 48 new drugs from insurance coverage in 2019. If you have insurance, it’s time to pay attention. Every year, PBMs like Express Scripts evaluate the clinical value and financial cost of prescription… Read More

piggy bank next to medicine bottle

This year has been tough for people with asthma. Pollen season ran especially long and just weeks after it peaked, we now have the California wildfires spreading smoke to the majority of US states and causing a spike in symptom flare ups. On top of that, asthma inhalers today are expensive. Popular ones can cost upwards of… Read More

piggy bank with money

The Trump administration recently issued a rule that allows a new kind of health insurance: short-term plans that offer some healthcare coverage for a lot less money than most other health insurance plans. These short-term plans can now last just under a year, with renewals for up to three years. But that lower price means… Read More

birth control dose pack

Birth control is back in the spotlight as Supreme Court Justice Kennedy announced on Wednesday that he will retire at the end of July 2018. This opens the door for a new Supreme Court Justice who will help shape important legal decisions as well as potentially rewrite old ones – including those around women’s health… Read More

dollar bills and prescription bottles

High-deductible health plans (HDHPs), those that require members to spend a large amount before they see any help from their insurance, are becoming the norm. In 2009, about 7% of large employers in the US offered only high-deductible plans. That percentage has more than quadrupled to 39% today. But just because HDHPs are becoming the… Read More

piggy bank with money

Let’s start with the bad news. Invokana, a tablet taken to treat type 2 diabetes, is really expensive. A 30-day supply of Invokana can cost around $550, and we may have to wait another six years to see a generic. But there is good news — there are ways to save. Here’s all the information… Read More

a doctor's prescription pad

As with other forms of coverage restrictions, insurance plans use quantity limits to ensure patient safety and control healthcare costs. Quantity limits define how much of a drug you can fill during a specific time period, but they can be a hassle. Here’s how to navigate your plan’s policies, so you can still get the… Read More

a doctor's prescription pad

To control drug costs and reduce the use of expensive medications, insurers have long relied on step therapy, a restriction on insurance coverage that requires patients to prove that less-expensive drugs are ineffective before getting coverage for a more expensive, higher-tier drug. Step therapy is another form of a prior authorization, but many argue that… Read More

clipboard with health insurance on it

Amid news of the White House’s new plan to curb high drug prices, a tragic story from 2009 has resurfaced of a woman who died after being denied coverage for her life-saving epilepsy medication. Even more upsetting is that this tragedy was due to a prior authorization, an insurance restriction that thousands of Americans deal… Read More

Medicare is spending more on brand-name drugs even as fewer of these drugs are being prescribed. Through Medicare Part D, the nation’s prescription drug benefit plan for Medicare beneficiaries, total brand-name medications cost 77% more in 2015 than they did just five years earlier, despite the number of these prescriptions actually dropping by almost 20%…. Read More