3 ms·
Yes, plans have pretty wide latitude on what they cover. ACA limited quite a lot by not only in plan design, but also what therapeutics must be covered. And y
by refurb 8mo ago
Yes, plans have pretty wide latitude on what they cover. ACA limited quite a lot by not only in plan design, but also what therapeutics must be covered. And you are correct, obesity is not one of them.
Medicare Part D (outpatient drugs) has wide latitude on what medicines they cover - it's actually smart for patients to shop their Part D plans if they are taking an expensive, chronic medication.
The only classes of drugs that Part D plans must included are:
Part D sponsor formularies must include all or substantially all drugs in the immunosuppressant (for prophylaxis of organ transplant rejection), antidepressant, antipsychotic, anticonvulsant, antiretroviral, and antineoplastic classes. (Page 28)
https://www.cms.gov/medicare/prescription-drug-coverage/prescriptiondrugcovcontra/downloads/part-d-benefits-manual-chapter-6.pdf https://www.cms.gov/medicare/prescription-drug-coverage/pres...