Obamacare drug coverage creates uncertainty for Nashville woman

Obamacare drug coverage creates uncertainty for Nashville woman (Image 1)

It's been an anxious last month for Anna Young since getting a letter that her state-sponsored AccessTN health insurance is ending on December 31.

The theory is that people like her will find similar plans for benefits and cost under Obamacare.

So far, that theory is not working for Young.

Sitting in the small Music Row law office where she works, the Nashville woman told a story that reflects what millions of Americans are going through in trying to find medical coverage to replace policies that are soon ending.

At the heart of her issue is finding a policy that covers the drug called Myfortic.

“These little pills are like gold to me,” she said showing News 2 the five pills she takes every day.

They are for a rare condition called myasthenia gravis which can unpredictably weaken the muscular system.

“I have run half marathons and I have been in a wheelchair. It's very unpredictable.  There is no rhyme or reason,” Young continued.

According to Young, most healthcare plans have refused to cover her particular drug, but the state program AccessTN did.

Young at first thought she would be able to find a comparable plan under the Obamacare Marketplace that would cover Myfortic, but the issues with the Web site, Healthcare.gov, did not give her any answers.

Turning directly to private insurers did little to lessen the uncertainty.

“I was put on hold. I have talked to multiple people and the bottom line is no one could tell me if it was covered, and if it was covered, how much it would cost,” she told News 2 with a shake of her head.

Under AccessTN, Young paid $330 a month with a deductible of $5,000.

She said the cost of the Myfortic was $100 every three months.

AccessTN was designed for people like her with conditions that private insurance would generally not cover.

In short, she was one those people categorized as “uninsurable” with a “pre-existing condition.”

Checking with other insurance carriers about the cost of the drug without coverage, Young said one of them told her it was $744 a month.

“That means I would be paying about $25 a day, instead of $1 daily,” she said.

The Nashville woman believes her quality of life is greatly connected to having the right drug for her condition.

“I have made important life decisions to make sure this drug is covered,” said Young. “I even moved back to Tennessee once I found out that AccessTN covered Myfortic.”

Now she just wants to find an insurer that covers the drug with a similar cost to what she is paying now.

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