Breast cancer survivor Ginny Mason was thrilled to get health coverage under the Affordable Care Act despite her pre-existing condition. But when she realized her arthritis medication fell under a particularly costly tier of her plan, she was forced to switch to another brand.
Under the plan, her Celebrex would have cost $648 a month until she met her $1,500 prescription deductible, followed by an $85 monthly co-pay.
Mason is one of the many Americans with serious illnesses — including cancer, multiple sclerosis and rheumatoid arthritis — who are indeed finding relatively low monthly premiums under President Obama’s law. But some have been shocked at how much their prescriptions are costing as insurers are sorting drug prices into a complex tier system and in some cases charging co-insurance rates as high as 50 percent. That can leave patients on the hook for thousands.
“I was grateful for the Affordable Care Act because it didn’t turn me down but … it’s like where’s the affordable on this one,” said Mason, a 61-year-old from West Lafayette, Indiana who currently pays an $800 monthly premium.
Before the federal health law took effect, Mason paid slightly more for her monthly premium on a plan that didn’t cover her arthritis or pain medications and some routine doctor’s visits.