QUESTION

I heard experts now say some women should take tamoxifen to prevent breast cancer. Does that mean it will be covered without co-pays?

Post enrollment issues | Individual Health Insurance
ANSWER

For some women, yes, tamoxifen must be available without co-pays. If tamoxifen is recommended for you and your plan is not grandfathered, your doctor may prescribe tamoxifen or another drug that experts say may reduce the risk of breast cancer, and your plan must cover it without any cost-sharing. This update to the preventive services benefit takes effect with plans that start after September 24, 2014. (CMS, ACA Implementation FAQs-Set 18, Jan. 9, 2014).

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Post enrollment issues