Richardin52
Well-known member
The affordable care act requires that drugs from every class of drugs be covered. The act leaves the decision up to states to choose benchmarks on drugs that insurance companies must meet.
If however a particular drug is needed by an individual The Affordable Care Act regulations demands that there must be an "exceptions process" in place that allows patients to request and gain access to clinically appropriate drugs that aren't covered by the health plan. So if a plan does not cover a particular drug that a patient absolutely needs their doctor can certify that it is "medical necessity" to extend coverage.
Insurance Companies often would not cover certain drugs before the Affordable Care Act and in some cases there was no recourse for a patient. The affordable care act fixed that. :clap:
If however a particular drug is needed by an individual The Affordable Care Act regulations demands that there must be an "exceptions process" in place that allows patients to request and gain access to clinically appropriate drugs that aren't covered by the health plan. So if a plan does not cover a particular drug that a patient absolutely needs their doctor can certify that it is "medical necessity" to extend coverage.
Insurance Companies often would not cover certain drugs before the Affordable Care Act and in some cases there was no recourse for a patient. The affordable care act fixed that. :clap: