For the majority of people living with epilepsy, epilepsy medications are the most common and cost-effective treatment for controlling and/or reducing seizures. Epilepsy medications are not interchangeable, and treatment of epilepsy is highly individualized - there is no "one size fits all" treatment option. Medication changes, limitations, or denials can be extremely dangerous.
The Epilepsy Foundation is a strong supporter of bills that prevent insurers from making mid-year changes to the prescription drug coverage included in healthcare plans. If prescription drug benefits are changed mid-year, beneficiaries can be left with higher out-of-pocket costs, or with no coverage at all for a necessary therapy. People with epilepsy choose their insurance based on the coverage details provided at the time of enrollment, and can be seriously harmed by unilateral mid-year changes in prescription drug coverage.
While insurers argue that mid-year changes in the market drive formulary changes, the Epilepsy Foundation believes that these costs should not be passed on to beneficiaries. People who buy insurance cannot change the terms of their plans mid-year; insurance companies should not be able to do so either.