RT Book, Section
A1 Burns, Lawton Robert
SR Print(0)
ID 1180253750
T1 Contracting for Prescription Drug Benefits: Role of Employers, Insurers, and Pharmacy Benefit Managers
T2 The U.S. Healthcare Ecosystem: Payers, Providers, Producers
YR 2021
FD 2021
PB McGraw-Hill
PP New York, NY
SN 9781264264476
LK accessmedicine.mhmedical.com/content.aspx?aid=1180253750
RD 2024/04/23
AB Until  the  1980s,  drug  coverage  was  not  a  distinct  benefit  in  employer-based  health  insurance.  Instead,  it  was  included  in  major  medical  plans  (when  it  was  included).  Such  plans  were  developed  by  the  commercial  insurance  companies  in  the  late  1950s  to  compete  with  Blue  Cross  and  Blue  Shield  (which  covered  the  services  of  hospitals  and  physicians,  respectively).  Major  medical  plans  served  as  the  start  of  “catastrophic  coverage,”  reimbursing  up  to  $10,000  in  expenses  that  were  not  restricted  to  specific  categories  of  hospital  or  physician  expense  (ie,  they  could  include  drugs).1  Coverage  was  usually  subject  to  an  overall  deductible  for  all  services  and  to  the  same  coinsurance  amounts  (usually  20%)  that  applied  to  all  medical  care.2  It  was  thus  a  limited  feature  of  private  insurance  plans.3