Once again, we get a reminder that the much-touted Massachusetts health reform model is far from a cure-all. State officials there are increasingly hearing from consumers who are cutting back on prescriptions and avoiding doctor's visits because they can't afford growing co-payments and deductible levels.
While this used to be a dilemma faced largely by families on publicly-financed plans, today it's true even for patients with private insurance, according to managers of patient-assistance hotlines run by the state. And officials for consumer group Health Care for All say calls to its help line are up about 65 percent from last year, with most callers struggling with deductibles and co-pays.
This concern is not surprising, given that co-pays for "third tier" brand name drugs not on the health plan's preferred list can be as much as $46 per prescription. What's more, co-pays for doctor's visits have inched up as well. All told, even insured patients can quickly incur large medical debt unless they ration their own care, observers note.
The state's Connector Authority, which oversees the law requiring most adults to buy health coverage, has set rules allowing out-of-pocket costs to reach as much as $5,000 per individual and $10,000 per family. However, Massachusetts legislators are considering ways to ease these costs, including one proposed law that would require plans to waive co-pays for drugs and devices used for chronic conditions.
To learn more about this issue:
- read this article from The Boston Globe
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