There are some critical changes taking place with Medicare that will affect the Alpha-1 community. Medicare Advantage plans may change their provider network at any time but must provide CMS with a 90 day notice prior to making this change. This could affect an Alpha’s augmentation therapy infusions and other essential coverage. For more information, visit Medicare.gov: Medicare Advantage Plans and 13 things to know about Medicare Advantage Plans.
For 2015 stand-alone Medicare Part D plans, premiums are likely to be slightly higher, there will be fewer plan choices in most states, and a number of name changes for current plans.
Medicare Open Enrollment is the one time of year when anyone who has a Medicare policy can make changes to their health and prescription drug plans for the next year. For people with Alpha-1, this is your opportunity to be sure your Alpha-1 augmentation therapy will be covered in 2015.
To review coverage:
- Compile a list of all your prescribed medications and dosages.
- Verify that your medications are covered on next year’s plan. Here are helpful resources to assist you:
- Enroll in Parts A and B
- Enroll in Parts C and D (Medicare Advantage Plans and Part D)
- Use the online Medicare Plan Finder
For personalized assistance:
- Medicare toll-free number: 1-800-MEDICARE (633-4227)
- State Health Insurance Counseling and Assistance Programs (SHIPs)
For more information:
The Alpha-1 Foundation Virtual Support Group hosted a webinar, Open Enrollment for Medicare and Private Insurance: How to choose the plan that will work for you.
- Download the presentation
- For Access to Care or Reimbursement issues and general questions regarding private insurance or Medicare, contact Barbee Bennington, Support Group & Program Coordinator, at firstname.lastname@example.org or 855-351-6610.
State Exchange Marketplace
The Alpha-1 Foundation acknowledges the generosity of the National Organization for Rare Disorders (NORD) and the National Health Council (NHC) for allowing us to use their tools for searching out the right Marketplace Health Insurance for Alphas and their families.
Please note: “Putting Patients First" does not include a search for augmentation therapy coverage; patients will need to confirm that coverage.
Private Health Insurance Toolkit
Having the tools you need to select the right health care plan for you and your family is very important. As the U.S. health care system undergoes changes, one important change is that individuals and small businesses will shop for and purchase health insurance through a state insurance exchange. Those affected by Alpha-1, as well as other rare disorders, need to make educated decisions on their coverage options. The Alpha-1 Association's Private Health Insurance Toolkit is to provide you with the information and resources to help you make the best possible choices in selecting a private health insurance plan.
It is essential to understand your family's current utilization of healthcare and learn to evaluate and compare medical insurance plans available in your area. The selection of an appropriate insurance plan can affect the health and finances of both the Alpha-1 patient and their family. This toolkit contains information, facts, resources and worksheets to compare the plans available to you.
- For questions about the Toolkit, contact Barbee Bennington at (855) 351-6610 or email: email@example.com.
- Download the toolkit
The Alpha-1 Foundation gratefully recognizes the following sponsors that made this publication possible: Baxter, CSL Behring, Grifols.
Content for this Private Health Insurance Toolkit was collected in collaboration with the Georgetown Health Policy Institute's and the American Plasma Users Coalition's (A-PLUS) State Exchange Project.
Special Thanks goes to: Accredo Health Group, Inc., Baxter Healthcare Corporation, Dohmen Life Science Services, Coram Specialty Infusion Services, National Hemophilia Foundation, Patient Services, Inc.
The framework for this Private Health Insurance Toolkit was graciously provided by the National Hemophilia Foundation ©