Obamacare Enrollment & Prescription Drugs: eHealth’s Rx Drug Tool Finds $1,900 In Potential Median Savings for Children

eHealth reports median potential savings of over $1,500; potential
median savings for children and young people ages 19 and under are
higher than any other age group at $1,973

MOUNTAIN VIEW, Calif.–(BUSINESS WIRE)–Over 30,000 people used eHealth Inc.’s (NASDAQ: EHTH) prescription drug
coverage comparison tool and found an average of $1,564 in potential
out-of-pocket savings during the first month of the Affordable Care
Act’s 2017 open enrollment period.

eHealth operates eHealth.com, the nation’s first and largest private
online health insurance exchange.

December 15, 2016 is the deadline to apply for Affordable Care Act (ACA
or “Obamacare”) health insurance plans with coverage beginning January
1, 2017. As the deadline approaches, eHealth has published figures that
highlight the amount of money people could save on out-of-pocket
prescription drug costs by selecting the health insurance plan that
covers their drugs at the lowest possible price.

eHealth’s drug coverage comparison tool lets people filter and compare
health insurance plans based on their personal prescription drug regimen
to discover which plans may cover their drugs at the lowest price.

All major medical health insurance plans cover prescription drugs to
some extent but in 2017 only 25% of all subsidy-eligible qualified
health plans (QHPs) cover prescription drugs before the medical
deductible is met. Plans often differ in the specific drugs they cover
and the out-of-pocket costs customers will face.

eHealth analyzed over 30,000 sessions where a customer used the drug
coverage comparison tool during the first month of the 2017 open
enrollment period and found potential savings if they switched to the
plan optimized for their prescription drug regimen:

  • The median amount that could be saved was $1,564
  • 65% found $500 or more in potential savings
  • 27% found $4,000 or more in potential savings
  • Men found more potential savings ($1,711) than women ($1,440)
  • By age group, potential savings were highest among children and young
    adults between the ages of 0-19 ($1,973) and 30-39 ($1,922) compared
    to other age groups
  • The average person entered 2.5 prescription drugs into the tool when
    comparing plans

“These results provide an incredibly powerful example of the need for
smart tools that can help people shop for and enroll in the best health
plan for their needs,” said eHealth CEO Scott Flanders. “I’m very proud
to be leading a company in this space that actually innovates to meet
the needs of real people. As our country is about to embark on another
debate over health care, I hope these results make it crystal clear to
policymakers that innovative companies like eHealth need to have a
bigger role in the next wave of reforms.”

Significant potential Rx savings for shoppers who use eHealth’s drug
coverage comparison tool

In the tables below, eHealth identifies median potential savings for
users of the drug coverage comparison tool who visited the company’s
website between November 1 and November 30, 2016.

When reviewing their coverage options through eHealth.com, shoppers were
prompted to enter their prescription drugs and dosages and review the
potential savings available by plan. These savings may only be realized
if the shopper enrolls in the optimal plan, takes the prescription drugs
in the dosages they have described, follows plan requirements for
purchasing drugs at the lowest cost, and would otherwise pay the
estimated retail price without the plan. See the methodology section
below for additional details.

 
Median potential savings overall
$1,564
 
 
Median potential savings by gender
Female:   $1,440
Male: $1,711
 
 
Median potential savings by age
Age 0-19: $1,973
Age 20-29: $1,805
Age 30-39: $1,922
Age 40-49: $1,907
Age 50-59: $1,663
Age 60-64: $871
 
 
Distribution of potential savings by % of tool users
$1 – $500 35%
$501 – $1,000 8%
$1,001 – $2,000 12%
$2,001 – $4,000 18%
$4,001 and higher 27%
 

Drugs most commonly entered by anonymous tool users

The most common drugs entered by health insurance shoppers into
eHealth’s drug coverage comparison tool include the following:

  • Lisinopril, a drug commonly used to treat high blood pressure and
    heart failure
  • Amlodipine, a drug commonly used to treat high blood pressure and
    coronary heart disease
  • Metformin, a drug commonly used to treat type 2 diabetes
  • Atorvastatin, a drug commonly used to treat high cholesterol
  • Levothyroxine, a drug commonly used to treat hypothyroidism
  • Adderall, a drug commonly used to treat ADHD and other conditions
  • Divalproex, a drug commonly used to treat seizure disorders,
    psychiatric conditions and migraines
  • Quinapril, a drug commonly used to treat hypertension and congestive
    heart failure
  • Simvastatin, a drug commonly used to treat high cholesterol
  • Synthroid, a brand-name version of levothyroxine

The most commonly entered drugs by age group include the following:

                     
Age 0-19   Age 20-29   Age 30-39   Age 40-49   Age 50-59   Age 60-64
Vyvanse Adderall Adderall Levothyroxine Lisinopril Amlodipine
Adderall Vyvanse Metformin Metformin Metformin Quinapril
Concerta Dextroamphetamine-amphetamine Abilify Lisinopril Atorvastatin Divalproex
Methylphenidate Lamotrigine Lamotrigine Adderall Levothyroxine Atorvastatin
Guanfacine Levothyroxine Levothyroxine Vyvanse Synthroid Lisinopril
 

Drugs most commonly entered that did not generate savings

The five most common drugs entered by health insurance shoppers into
eHealth’s drug coverage comparison tool which did not yield potential
savings for customers include:

  1. Saxenda, a drug commonly used to regulate appetite
  2. Imatinib, a drug commonly used to treat certain types of cancer
  3. Keytruda, a drug commonly used in cancer immunotherapy
  4. Clozaril, a drug commonly used to treat schizophrenia
  5. Viagra, a drug commonly used to treat erectile dysfunction in men

Methodology

In preparing the analysis above, eHealth reviewed more than 30,000 user
sessions in which anonymous consumers utilized the drug coverage
comparison function at eHealth.com between November 1 and November 30,
2016 and found potential savings. Potential savings are calculated based
on the estimated full retail price for the drugs entered by consumers.
The estimated full retail price is based on figures obtained through
insurance carriers with whom eHealth has a relationship or through other
sources. Savings figures are based only on plans available through
eHealth.com and may only be realized if the consumer chooses to enroll
in the plan identified as offering the highest savings, and follows any
plan requirements for obtaining the lowest drug prices (such as only
buying medically necessary drugs from in-network pharmacies and
following step therapy procedures). Although the comparison tool
attempts to use the latest data available, plans may change their drug
formularies or coverage rates or otherwise not provide the latest
correct data in some instances. After using the drug tool to identify
one or more potential plans to purchase, consumers should check a
selected plan’s formulary and benefit details documentation to confirm
drug coverage.

eHealth

eHealth, Inc. (NASDAQ: EHTH) owns eHealth.com, the
nation’s first and largest private online health insurance exchange
where individuals, families and small businesses can compare health
insurance products from leading insurers side by side and purchase and
enroll in coverage online. eHealth offers thousands of individual,
family and small business health plans underwritten by many of the
nation’s leading health insurance companies. eHealth (through its
subsidiaries) is licensed to sell health insurance in all 50 states and
the District of Columbia. eHealth also offers educational resources and
powerful online and pharmacy-based tools to help Medicare beneficiaries
navigate Medicare health insurance options, choose the right plan and
enroll in select plans online through Medicare.com (www.Medicare.com),
eHealthMedicare.com (www.eHealthMedicare.com)
and PlanPrescriber.com (www.PlanPrescriber.com).

For more health insurance news and information, visit eHealth’s Consumer
Resource Center
.

Contacts

DMA Communications for eHealth, Inc.
Sande Drew, 916-207-7674
sande.drew@ehealth.com
or
eHealth,
Inc.
Nate Purpura, 650-210-3115
nate.purpura@ehealth.com

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