Goals of the Bill
- Prohibit changes in drug formularies during the plan year for individual and group health policies
- Prohibit the removal of a drug from the policy’s list of covered medications for the duration of the consumer’s plan year unless the drug is ruled unsafe by the FDA
- Prohibit the reclassification or moving of a drug to a higher cost-sharing tier on the policy’s list of covered medications for the duration of the consumer’s plan year
- Allow for the addition of medications to the plan to expand its drug coverage
Impact on Connecticut Patients
Ensuring that the drug coverage a consumer signed up for remains consistent throughout the length of their entire plan year is essential to protecting the health and well-being of all Connecticut residents and their families.
Without reliable drug coverage, a consumer may find themselves unexpectedly losing coverage for medications they have been taking regularly as prescribed by their doctors.
Allowing for changes to be made during the plan year can disrupt the consistent use of medications necessary for maintaining one’s health and potentially result in worsening of a patient’s condition, the risk of hospitalization, and increased health costs associated with the disrupted drug treatment.
Creating a protected timeframe from drug formulary changes would allow for better budgeting and provide patients and their doctors with adequate time to seek an exception to formulary changes in the new plan year if needed.