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Cost of Prescription Drugs Affecting BCBSNC Premium Rates

bigstockphoto_medication_and_prescriptions_311655Under the Affordable Care Act, health care costs have risen across the board for both consumers and insurance companies, as well as health care providers.  Increased visits to the Emergency Room and an increasing number of ACA members with chronic health issues have put a strain on the health and health insurance industry alike.  A recent review of Blue Cross Blue Shield NC claims data showed that of the many higher health care costs among ACA business, prescription drug costs rose more than any other category of medical care in the first half of 2015.  In fact, prescription drug costs rose 33% in just one year, with a prescription claims average of $96.70 per month for each ACA customer January – June of 2015.  Although pharmaceutical companies are currently being reviewed for how they price new prescription drugs, that 33% increase has still greatly affected the cost of health insurance.

There are viable reasons the cost of prescription drugs are on the rise.  There are many new and improved medications as well as specialty drugs that can be very expensive to develop and administer.  Maintenance drugs for chronic conditions are also pricey and being used more than ever.  For example, the Mayo Clinic cited that cancer drugs have risen from an average price of about $10K a year in 2000 to more than $100K in 2012!  Although those drugs may be more effective and have less side effects, they are also more expensive.  New diabetes drugs as well are retailing at about $400 a month, whereas the older class of diabetes drugs were as little as $4 a month for the generic brand.  Again, with every advantage in new prescription coverage comes an increased cost to the consumer and the insurance company.

On a national level, the realities of the Affordable Care Act and its impact on the health insurance market are being fully realized as ACA customers experience more chronic conditions and continue to use their health benefits more often and at a higher rate than could have been accurately predicted.  This has affected the cost of health insurance, as insurance companies all over the nation fight to stay solvent.  In fact, Tennessee’s two largest health plans available on the ACA exchange requested a 2016 rate increase of 36-44% based on 2015 claims data and the Oregan insurance commissioner actually ordered several companies’ rates to be higher than requested because of concerns that the companies would simply fold otherwise.

As Blue Cross Blue Shield of North Carolina prepares for 2016, consumers will likely see a rate increase in their monthly premiums and may be asking why.  The answer is simple.  The price of health care and prescription drugs is on the rise and new ACA consumers are using their benefits at a higher rate for more expensive services.  As always, BCBSNC is committed to offering members the very best coverage available at a price that is competitive in this new market and will continue to provide the residents of North Carolina health coverage they can depend on.

For more information on Blue Cross Blue Shield of North Carolina insurance coverage, the Marketplace and healthcare gov to apply for your subsidy, please visit our website at www.nchealthplans.com or call our toll free number 888*765-5400 and speak with one of our experienced and professional agents.  Let us help you navigate through the Health Care Reform changes in accordance with the new regulations of The Affordable Care Act, also known as Obama care.

 

 

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