COLUMBUS (WCMH) — State lawmakers want to take steps against health insurance companies who prohibit their customers from getting help from third-parties to pay deductibles.
The bipartisan group of lawmakers is targeting a practice some health insurance companies use that can be implemented at any time without warning.
“This bill strives to protect patients who are being blindsided by unfair policies when learning they owe thousands of dollars because of unmet deductibles,” said Rep. Susan Manchester (R-Waynesfield).
Manchester is talking about patients like Abbey Haudenshield’s two sons.
Both the boys have Hemophilia and their prescribed medication costs $32,000 a month and they get help paying for it from a third-party co-pay assistance program.
“We meet our out-of-pocket maximum, which for my private insurance is about $8,000 a year, and we would meet that on the first refill of the medication in the year,” she said.
That program can’t be used to pay down their deductible anymore — their insurance company doesn’t allow it.
“They’re getting the money one way or another, so why should they care if a co-pay program is covering it or if I’m covering it,” Haudenshield said. “It’s, you know, the portion is getting paid.”
Representatives Manchester and Thomas West (D-Canton) said this isn’t right.
Both representatives have tried to resolve the issue without legislation, but now they feel they have no other choice.
In the meantime, they said consumers should be aware of what their health insurance policy does and doesn’t allow.
“It’s so important for all of us to really look at our plans and see if we have those types of clauses,” West said.
To do this, customers can call their health insurance providers and ask if their policies allow for deductibles to be paid with funds from charities, churches, or any third-party source.
NBC4 reached out to a number of insurance companies serving Ohio to ask if and why they have these practices. None of them responded with an explanation.
