“We’ve seen people who would prefer to be on phototherapy, but can’t afford $500 in copays over eight weeks, so they end up stepping up to a systemic treatment,” says Howard.
In addition, although dollar limits on benefits aren't allowed, plans typically limit the number of sessions for certain treatments such as physical therapy.
Because of the rocky rollout of the exchange websites in many states, many consumers have found it difficult to get basic information about premiums and plan deductibles, say experts. Many don’t know which providers are in the plan networks or what benefits the plans cover.
“As more and more people become covered and as people start to use their plans, we’ll see if the cost protections in the plans are sufficient, and directed toward getting people the care they need,” says Sara Collins, a vice president at the Commonwealth Fund.
Kaiser Health News is an editorially independent program of the Henry J. Kaiser Family Foundation, a nonprofit, nonpartisan health policy research and communications organization not affiliated with Kaiser Permanente.
Tue, Dec 24 2013