Out-of-pocket costs for specialty drugs under the Affordable Care Act increased 16 percent from 2016 to 2017, according to a reportfrom HealthPocket.
While prescription drug coverage comes standard with Obamacare plans, not all medications prescribed to individuals will be paid for.
“For a plan to help pay for a drug, the drug must first be included on the health plan’s formulary,” the report states. “Drugs that are off-formulary are not only paid for completely out-of-pocket by the enrollee but those expenses do not count towards the annual cap on out-of-pocket spending.”
The report found that for Obamacare’s silver plan, a Humira Pen, a specialty drug that treats arthritis and Crohn’s disease, will total $1,889.66 in out-of-pocket costs, which increased $262.45 in price since 2016. Harvoni, a specialty drug used to treat those with hepatitis C, will total $12,590.60 in out-of-pocket costs, which increased by $1,762.59 in one year.
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