12.2.16

A recent survey found that many Tennesseans are being forced off prescribed medications by health insurance companies.

According to the Global Healthy Living Foundation, which conducted the survey, a majority of Tennesseans with chronic and/or mental illness are experiencing midyear prescription coverage reductions, which frequently force them to switch off their provider-prescribed medications.

“Reductions in coverage include increased out-of-pocket costs, eliminating a drug from the formulary entirely or other restrictions around access,” reported the Tennessee Patient Stability Coalition, a group of 16 patient and provider organizations led by the US Pain Foundation.

This harmful practice, sometimes called “non-medical switching,” occurs when changes are made to a health plan’s available and approved medications in a way that puts financial pressure on patients to stop getting their prescribed medication, shifting them instead onto a “preferred” or cheaper drug.

This means patients aren’t receiving the benefits promoted to them when they first chose their health plans. And it poses dangerous consequences.

Patients pressured to take a different drug because of financial rather than medical reasons can face terrible results: Unanticipated side effects, disease progression, relapse. They might need to schedule additional visits with doctors or be hospitalized, increasing their overall expenses for health care.

This infographic shows the problems associated with non-medical switching by insurance companies.

You can read more about the issue in Tennessee here.

It’s not just in Tennessee. People all over the country are experiencing discrimination from insurance companies trying to avoid paying for the treatments their doctors prescribed, to avoid having chronic disease patients enroll on health plans and more.

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