As in Consumer Driven Health Care, but this time from a different perspective: prescription medications. Under the typical CDHC model, meds are subject to the high deductible that drives the plan. Once that deductible (which includes meds, office visits, etc) is met, then they’re covered at the higher rate (usually 100%).
But as we all know, prescriptions account for a disproportionate slice of the health care expense pie. So, is there some way to bring those costs more in line, to underscore the savings available in CDHC?
Well, yes: “Medco Health Solutions (has) announced major additions to its consumer-directed pharmacy plan that promotes the use of preventive and chronic medications by lowering the out-of pocket costs of these drugs to consumers enrolled in high-deductible health plans.”
As we’ve discussed before, HSA’s (Health Savings Accounts) are the primary vehicle for CDHC (although certainly not the only one). Under new guidelines, HSA plans can include a deductible waiver for certain preventive meds. In other words, that lipitor you’re taking to lower your cholesterol, or the meningitis vaccine for your son headed off to college, can skip the deductible and go straight to the 100% reimbursement level. Not bad.
Medco’s lowering their price for such drugs, which amplifies the savings already built into the HSA. Much as using a PPO network when choosing a doc, using Medco preventive meds can lower one’s out-of-pocket, as well. These discounts really only affect those with CDHC plans that require some co-insurance after the deductible; obviously, if you’re already at 100% reimbursement, the discounts are irrelevant (at least to you).
This is one more arrow in the CDHC quiver. It’ll be interesting to see what part of our healthcare delivery system steps up next.