Problem with enforcement of Obamacare? Just recieved call about annual maximum limits...
on prescription drugs, which are considered an essential health service.
Got a call from a woman about her copays for her medications tripling this month, look in the system, and the insurance is paying none of it, she's now at 100% copay, with a simple message, Benefit Maximum Exceeded. Looked at her plan documents, and it shows a 1,000 dollar annual limit on her plan. That means, for the rest of this year, she has to pay 100% of the cost for her prescription drugs, and as you can gather, given how early in the year it is, her drugs are rather expensive.
I looked it up, and some grandfathered plans are allowed annual benefit limits, however, this plan that she is on wasn't instituted until 01/01/2014, after the ACA was put into effect. I don't know how this is legal, whether I should report it, or if I'm missing something. The only thing I do know is that this is complete bullshit, seriously, she already is out of pocket for premiums, now the plan won't pay for any prescriptions for the rest of the year? Almost better off not being insured in that case.
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