It’s the new way health insurance companies are trying to discriminate against "costly" patients and push those patients off their plans.
And it has arrived with a vengance in North Carolina.
Last week, BlueCross BlueShield of NC sent thousands of letters to cancer and HIV patients in North Carolina telling them that their medications will be moved to the highest (most costly) tier of their prescription medication formularies.
Approximately 36 cancer drugs and approximately 32 HIV drugs -- drugs that have no generic alternatives -- will skyrocket out of reach of existing patients. The cancer medications on the adverse tiering list include treatments for ovarian cancer, breast cancer, colon cancer, prostate cancer, leukemia (blood cancer), lymphomas, lung cancer, testicle cancer, intestinal cancer, and on and on.
There is a bit of a new twist in the BlueCross adverse tiering situation in NC that is different from previous reports and studies on adverse tiering in other states. This isn't just happening to small group plans or individuals purchasing insurance on the ACA (Obamacare) exchange. Even if you’re on an employer-based insurance plan in a large pool, BlueCross is jacking up your prescription tier to the most costly level to push you off of their books.
In one example from BlueCross' adversely tiered cancer and HIV medication list in NC, a person on a silver level comparable ACA plan paying a $45 monthly ($540 annually) co-pay for one prescription will now pay almost $7000 annually for the same medication -- an over 1200% increase to absorb in just a few months -- for just one medication!
This new discrimination has been rolled back by other insurance companies (Cigna, CoventryOne, Humana, etc) in other jurisdictions like Florida and Washington, DC.
This does not have to happen in NC. This was rolled back in other states.
Adverse tiering is simply a ploy to push some costs off the books of the virtual health insurance monopoly which is the "non-profit" BlueCross BlueShield of NC.
BlueCross BlueShield of NC should roll back this abhorrent practice against cancer and HIV patients.
Mainstream and social media need to shine a bright light on this. If you know a cancer or HIV patient who got that letter, tell them to take it to the local newspaper or TV station.
Regulators from the federal Dept of Health and Human Services (Office of Civil Rights) down to state level regulators need to get ahead of this before it begins to impact treatment on patients in NC.
Health advocacy organizations for cancer and HIV patients need take this on immediately. It is a winnable, worthwhile and just fight