Protecting Access to Disease Modifying Therapies in Montana

Commissioner Lindeen and MS Activist Deanna McCann

Many people living with MS rely on disease modifying therapies to delay and reduce symptoms of the disease. These medications can be very expensive, and high out of pocket costs can hinder access to treatment.

In Montana, and many other states, insurance plans typically cover these medications in specialty prescription drug tiers requiring patients to pay 20, 30, even 50 percent of the drug cost in co-insurance. The financial burden placed on patients relying on specialty tier medications is often much higher than cost-sharing for other tiers of prescription drugs and plan benefits.

An inquiry by the National MS Society and its activists resulted in a change that will make it easier for consumers to access the medications they need. The Montana Commissioner of Securities and Insurance, Monica Lindeen, investigated the cost-sharing structures proposed by insurers for 2015, and objected to some of the plans.  As a result, insurers now offer plan options with graduated co-pays, ensuring that consumers on those plans will pay no more than $250 per month for their disease-modifying MS therapies.

Press at the National MS Society office in Billings, MT

In addition, the Commissioner’s office will make sure healthcare navigators are trained to help individuals who need high cost medications select a health insurance plan that is best for their needs.

On Friday, October 10th, Commissioner Lindeen hosted a press conference at the National MS Society's office in Billings and invited MS Activist Deanna McCann to speak on behalf of people affected by MS and other chronic diseases. Deanna shared her story of being diagnosed as a young mother unable to pay the high cost for disease modifying medication and thanked Commissioner Lindeen for changing the way Montanans will pay for their specialty tiered medications. 

The work of activists like Deanna makes a difference in the lives of people affected by MS. The National MS Society continues to monitor insurance market plans across the country to ensure access to quality and affordable health care. As Deanna notes, “insurance coverage can be confusing to anyone.” With the help of MS activists, we can promote education, transparency, and access for people living with chronic conditions.

Read more about the press conference here.

Want to share your story? Ready to take action? Contact us!

What a day in Olympia!

For those of you who missed it, the Day of Activism on January 30th was incredibly informative and motivating! Between the excellent guest speakers, the education we received on the legislative agenda, and the surprising dry weather, the group of about sixty activists were ready to tackle the issues with our legislatures.

As you have seen in previous posts from last week, SB6241/HB2435, the bills aimed at Capping Out of Pocket Expenses are gaining traction! The testimony at the public hearing was attended by a coalition of consumers (including representatives of the Greater Northwest Chapter of the National MS Society) sharing their stories and the impact that the costs of chronic illnesses have on their lives. Please share your story with your representatives and let them know that you support these bills.

The National MS Society has also thrown its support (along with Healthy Washington Coalition) behind consumer driven development of the Health Insurance Exchange required by the Affordable Care Act in 2014. It is crucial that the exchanges are developed to serve the consumer and patients’ interests and not hi-jacked by the insurance companies.

As we have for the past few years, we were again begging our legislatures to STOP the CUTS to the state’s safety net programs. With Basic Health, Disability Lifeline, and aspects of Medicaid on the line, NOW is the time to take a stand. Did you know the state is considering ending the prescription benefits for Medicaid? That alone will devastate the MS Community.

Right now is when your legislators need to hear from you! Call 800-562-6000, visit, or email http://www.leg.wa.gov/pages/home.aspx (click here to find your legislators) and let them know that they MUST protect the state safety net programs!

Stay tuned for updates on the current legislative session and what to follow for the upcoming election in November. It’s Time for Action! Washington.

Cheers - Holly