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@lindabreathless
I read an article stating that some major insurers are scaling back advantage and part D plans fro 2026 and some people might lose their coverage if it is dropped in certain areas of the country. These changes are a response to financial pressures, including changes to government funding and rising healthcare costs. This has led insurance carriers to scale back their offerings in less profitable regions. I wonder if they will also scale back coverage of specialty drugs as well as dropping locations. Probably will.
Replies to "@lindabreathless I read an article stating that some major insurers are scaling back advantage and part..."
@irenea8 just found this post from you by accident ... I am on Humira which treats a couple of autoimmune conditions. It is a specialty drug. It has kept me in remission for 7+ years. Just got a notice from my Aetna Medicare Advantage plan that they are taking it off their formulary for 2026 and suggesting we work with our doctors to transition to the "biosimilar" which came on the market a couple years ago at a fraction of the price. Humira is phenomenally expensive and I think I read it's one of the most profitable drugs in the world. My GI doctor's office had warned me that a lot of insurances are no longer covering it in 2026. So that's a long way of saying that yes, specialty drugs are being cut back. At least this one (Humira).
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@irenea8 The possible problem is even when people and organizations make decisions that they think are good for them and us it 'ain't' necessarily so. That Drug out of pocket amount sounds great to us but it doesn't sound great to those providing the drug plans. As we know the Brinsupri is very costly and one of the factors that makes it hard for us and the drug companies providing the drug plans. What do you think, do you think that is part of it? The why of it as to why they are leaving areas or dropping coverages???
Barbara