Almost half of the state and federal health insurance exchanges didn't clearly explain which drugs would be covered in each available plan, a new survey from Avalere Health found.
Reviewing 85 plans sold in five states running the federal exchange and 12 state-based marketplaces, Avalere found drug formularies were difficult or impossible to find in 48 percent of those plans. And 38 percent of plans included no information about covered drugs.
Avalere Health said the missing drug data presents "significant obstacles" to consumers trying to assess value on their search for health coverage.
"As the open enrollment period for the inaugural year of the exchanges has just ended, it is a good time to take stock of the consumer shopping experience and identify ways to improve transparency in future years," said Avalere Health Vice President Caroline Pearson. "Providing understandable and accessible information about the providers and drugs included in exchange plans is essential to helping enrollees make informed purchasing decisions that balance premium against scope of coverage."
Although HealthCare.gov and some state websites, including Colorado, Connecticut, Maryland, Minnesota, Nevada and New York, provided a link to drug formularies for each available plan, many of the links weren't direct. Sometimes the links merely sent consumers to the insurer's homepage, requiring them to navigate a separate website before finding information about covered drugs, the survey found.
"It's very important that we focus on how to make plan comparison much easier than it was in most exchanges in the first year," Robert Krughoff, president of Consumers' Checkbook, a nonprofit group that developed a model comparison tool, told the Associated Press. "None of the sites has done a good job helping consumers compare out-of-pocket costs. That results in consumers wasting thousands of dollars a year."
To learn more:
- here's the Avalere Health survey
- see the Associated Press article