The Ohio AIDS Coalition has compiled a document that identifies HIV drug coverage for every Marketplace and Medicaid Managed Care plan. In this document you will find:
- A summary of the drugs that are excluded from each insurance provider’s drug formulary with broader observations and additional notes
- The summary page does not include high tiered medications, and should be viewed on each insurer’s individual page.
- A summary of what percentage of covered HIV drugs require prior authorization, are listed as specialty medications, and tier structuring
- The summary page does not include specific information about specific medications. This information should be viewed on each insurer’s individual page.
- An in-depth drug identification for each of the insurance provider’s formularies
- Each tab is devoted to a different provider, with a key to the right and notes at the bottom of each page.
- Every drug has been checked in both generic and brand name.
Disclaimer: This analysis is meant to be used as a tool for guidance and serves merely as a snapshot in time. Consumers must continue to self-advocate by examining each plan and determining if it is right for them. Before selecting a plan, all individuals should contact the plan provider to confirm the accuracy of all information. As plans change through our advocacy efforts we will attempt to keep this up-to-date.
Any discrepancies found within these documents should be reported to OAC so that the documents can reflect accurate information.
OHIO 2017 FORMULARY ANALYSIS FOR QUALIFIED HEALTH PLANS– UPDATED 11/8/16
OHIO 2017 PLAN ANALYSIS FOR QUALIFIED HEALTH PLANS– UPDATED 1/1/17
OHIO 2016 PREP QUALIFIED HEALTH PLAN ANALYSIS– UPDATED 1/15/16
OHIO MEDICAID MANAGED CARE PLAN PDL ANALYSIS– UPDATED 2/5/16