<p>I have more info about 2014 plans in Ca that I doubt anyone on this thread is aware of but I can’t reveal it now. When I get further confirmation (tomorrow) I will let everyone know.</p>
<p>We don’t have any prescriptions. But. I heard some bad things. I just don’t have any verification. Don’t want to spread false info</p>
<p>Check online first. Eg:
<a href=“http://www.bcbsil.com/PDF/rx/rx_formulary_std_5tier_il.pdf[/url]”>http://www.bcbsil.com/PDF/rx/rx_formulary_std_5tier_il.pdf</a>
Anthem’s was set in August. The web page doesn’t indicate when the list was made public, but it’s online. MI BCBS is. My state is. A few seem to be up for Texas. Google, if needed. (I initially had a heck of a time finding mine on the BCBS web site.)</p>
<p>Poetgirl,</p>
<p>what I understand not all medications are covered by all insurances. So, if you have to take certain medications (for example for chronic condition) make sure it is on the preferred drug list of you insurance of choice.</p>
<p>Also, I have heard that drug co-pays are very high on some insurances.</p>
<p>ETA: Drug formularies are subject to change, so I suspect in the future the preferred drug list is going to expand.</p>
<p>The real issue is whether non-formulary drugs are counted against the deductible and the out of pocket maximum and whether the list of formulary drugs has been narrowed for 2014 plans. If you are taking a prescription for a chronic ailment and it is not counted against your deductible and out of pocket maximum, the cost can rapidly become a huge issue.</p>
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<p>From what I understand, they do not.</p>
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<p>If you have a chronic ailment, there will be a drug on preferred list for that condition, but it might not be your preferred list. However, there is a process of exception that your doctor can help you with.</p>
<p>Quite frankly, this is not necessarily different from pre-ACA plans. The big difference might be the extent of choices on drug formulary.</p>
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<p>As long as the meet the minimum requirements of ACA they certainly can. (Not sure why that is an issue or a surprise.)</p>
<p>[AIDS</a> advocates say drug coverage in some marketplace plans is inadequate - The Washington Post](<a href=“http://www.washingtonpost.com/national/health-science/aids-advocates-say-drug-coverage-in-some-marketplace-plans-is-inadequate/2013/12/09/0fca0fd0-5d18-11e3-95c2-13623eb2b0e1_story.html]AIDS”>http://www.washingtonpost.com/national/health-science/aids-advocates-say-drug-coverage-in-some-marketplace-plans-is-inadequate/2013/12/09/0fca0fd0-5d18-11e3-95c2-13623eb2b0e1_story.html)</p>
<p>I want to know which popular drugs were on the list in 2013 will not be on the list in 2014.</p>
<p>Anthem added a drug to their list after I told them my daughter’s drug was not in tbe list. This was in 2013.</p>
<p>If I had all the UCs and Stanford in my network, I wouldnt complain too much. Oh! I do. Me and everybody else that buys an EPO or PPO Plan from Anthem Blue Cross in Ca.</p>
<p>Yes, it is different. My 2013 plan reimbursed me for non-formulary drugs and also counted it against my deductible and out of pocket maximum</p>
<p>“If I had all the UCs and Stanford in my network”</p>
<p>I will have more for you tomorrow about this.</p>
<p>Your old account was at Blue Shield.</p>
<p>Yes, but I doubt Anthem was any different.</p>
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<p>Did your physician advocate on your behalf?</p>
<p>No, it is a covered benefit under the plan</p>
<p>If it is covered, then it is on preferred list, right?</p>
<p>I was supposed to have my daughter’s physician fax a letter to Amthem requesting the drug be covered. Never happened. The drug was added anyway.</p>
<p>Non-formulary is a covered benefit? Or non-formulary had one or more approval procedures/options? That’s what I am seeing. Assuming you read how they discuss this.</p>
<p>Under my current plan, non-formulary drugs are covered but with a higher copay. The important part is that it is counted against the deductible and the out of pocket maximum.</p>
<p>I suspect that the government is going to lean on some of these plans. Insurance companies are required to have a prescription drug benefit. Essentially, they’re required to cover your drugs for whatever condition you get. But they might not cover the drug you want to take for that condition.</p>
<p>I suspect there will be jockeying back and forth about whether particular carriers’ formularies are adequate, and some insurance companies will be forced to expand their lists.</p>
<p>Does Blue Shield use a tiered system when covering drugs?</p>