Prescription coverage after changing insurance — are there “continuity of medication” requirements?
My employer switched health insurance companies in May. Our old insurance covered the prescription drug Wegovy but it’s not on the new company’s formulary.
I’ve read that insurance companies can be compelled to continue covering medications under a “continuity of medication management” provision, which is supposedly a requirement of the ACA. This Reddit comment says that this should last for a year and shouldn’t make you to jump through hoops like Step Therapy.
Unfortunately I’m not able to find anything corroborating this on the Internet. The only thing I can find is the ACA’s continuity of care provision which allows you to keep seeing a specific provider if you’re in the middle of active treatment. Our company’s “Health Advocate” also only knew about that rule and didn’t have any advice for getting continuing prescription coverage.
Is this a real requirement or was that Redditor mistaken? If this is real, does anyone know the particular terms or key words that I should use in my request?
