On July 15, the Minnetonka, Minn.-based UnitedHealthcare, which insures more than 26 million Americans, and which is the largest privately owned U.S. health plan by market share, has taken the lead among major U.S. health insurers, in announcing that, beginning as early as January 1, 2023, it will eliminate out-of-pocket costs for individuals insured through some of its standard fully insured group plans. UnitedHealthcare is the first major national health insurer to make such an announcement.
The announcement, posted in the form of a press release to the company’s website, began thus: “UnitedHealthcare will eliminate out-of-pocket costs in standard fully insured group plans for certain preferred prescription drugs, including insulin and several drugs used to treat emergencies such as severe allergic reactions, hypoglycemia, opioid overdoses, and acute asthma attacks. This new standard offering will be available to group fully insured plans potentially as early as January 1, 2023, subject to any required regulatory approval. Eliminating out-of-pocket expenses for these critical medications can help reduce the burden of medical costs on consumers and encourage better medication adherence, reducing the risk of complications and expensive hospitalizations,” the press release stated.
Further, it stated, “These actions are part of UnitedHealth Group’s ongoing efforts to ensure people get the drugs they need and to make health care more affordable. Offering these preferred drugs at $0 cost share builds on past moves by both UnitedHealthcare and Optum Rx, including point-of-sale discounts that have delivered millions of dollars of savings directly to consumers at the pharmacy counter.”
And the press release quoted Brian Thompson, CEO of UnitedHealthcare, as stating that “High prices are a significant barrier to prescription drugs for many people, so we are using our unique capabilities to deliver savings for consumers. We are doing what we can to shield people from the prices set by pharmaceutical companies, and hope all stakeholders also will act to make prescription drugs more affordable.”
Further, the press release went on, “In addition to insulin, four preferred emergency use medications will be included in the new standard offering and will also have a $0 cost share: Epinephrine – severe allergic reactions; Glucagon – hypoglycemia; Naloxone – opioid overdoses;Albuterol – acute asthma attacks.”
UnitedHealthcare’s announcement could influence other health plans. As the website ValuePenguin notes, UnitedHealthcare is the largest health insurer in the U.S. by percentage of market share, with 12 percent of total U.S. market share, followed by Anthem, which on June 28 became Elevance Health (11 percent), Centene (10 percent), and Humana (7 percent).
As noted at the bottom of the press release, “In the United States, UnitedHealthcare offers the full spectrum of health benefit programs for individuals, employers, and Medicare and Medicaid beneficiaries, and contracts directly with more than 1.5 million physicians and care professionals, and 7,000 hospitals and other care facilities nationwide. The company also provides health benefits and delivers care to people through owned and operated health care facilities in South America. UnitedHealthcare is one of the businesses of UnitedHealth Group (NYSE: UNH), a diversified health care company.”
