Ohio Insurance Plan Analysis

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 Equitas Health so that the documents can reflect accurate information.

2017 Plan Analysis for Qualified Health Plans
2017 Summary of Formulary Exclusions

2016 Summary of Formulary Exclusions
2016 PrEP Silver Plan Analysis