Thursday, July 12, 2007

Prescription drug requirement to get more review

By Alice Dembner, Globe Staff

State officials today voiced support for a plan that could cut the cost of monthly health insurance premiums for basic coverage that includes prescription drugs.

Staff members of the Commonwealth Health Insurance Connector, with the help of pharmacy consultants, proposed a plan that would add only $20 a month to premiums, far less than the typical $50 to $55.

The plan mandates use of generic drugs whenever possible and would cover all generics for a small copayment. However, it would require a deductible of $500 or more for most brand name drugs, in addition to sizeable copayments. Brand name drugs account for the bulk of the cost.

Members of the connector board generally endorsed the proposal, although they postponed a vote until they see how insurers would apply it in real life.

“I like the idea, but I’d rather see lower deductibles and higher copays on brands,” said Celia Wcislo, a board member and assistant division director of labor union 1199 SEIU.

Louis Malzone, executive director of the Massachusetts Coalition of Taft-Hartley Funds, a group of private health plans jointly managed by unions and management, was concerned about how the proposal would play out for older insurees, who face higher premium prices.

As the next step, staff members will get actual premium prices and a proposed schedule of copayments and deductibles from the six insurers who are offering unsubsidized health coverage through the connector.

The board would then evaluate the proposal as an alternative to rules that require all residents to have health insurance that includes drug coverage with no more than a $250 deductible.

Posted by Karen Weintraub at 02:51 PM

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