archive-org.com » ORG » H » HEMAWARE.ORG

Total: 1100

Choose link from "Titles, links and description words view":

Or switch to "Titles and links view".
  • Insurance Information Taught to Social Workers | HemAware
    so that they can better understand it and put together a plan on how to deal with it The theme of this year s conference was Navigating the Maze Your Road to a Better Understanding The symposium offered a variety of sessions on insurance issues including disability high risk pools private insurance and healthcare reform s expected effect on the bleeding disorders community Local representatives from the regional offices of Medicare and Medicaid also offered expert advice Seasoned social workers presented case studies and breakout sessions facilitated problem solving skills Each workshop has had a different focus that is in tune with the current healthcare issues at the time says Michael Bradley vice president of healthcare economics and reimbursement for Baxter BioScience Now that healthcare reform is a reality it is more important than ever to stay up to date on all insurance related matters Pennick agrees I felt this sym posium was one of the best we ve had because there are finally changes to healthcare that really help the community We ve all dealt with families where parents are changing jobs because their 3 year old has reached the lifetime cap With the new healthcare reform we are finally learning about something that can really help our patients instead of just giving them bad news The Social Work Symposium was sponsored by Baxter BioScience View the discussion thread Life Stages Infants Children Teens Young Adults Adults Aging Research Treatment Hemophilia A B von Willebrand Disease Rare Bleeding Disorders HIV Hepatitis C Surgery Transplants Researcher Profiles Health Wellness Fitness Nutrition Taking Charge Pain Management Parenting Family Parenting Family Hemaware Jr Women Women s Bleeding Disorders Carriers Watchdog Insurance Blood Safety Advocacy Community HemAware Blogs HemAware Videos HemAware Photos Chapters in Action Global Spotlight Community Voices En Español Related Most

    Original URL path: http://www.hemaware.org/story/social-workers-soak-insurance-information (2016-02-18)
    Open archived version from archive


  • Lifetime Insurance Limits | HemAware
    Small to medium sized employers usually purchase a group insurance plan directly through a health insurance company In this scenario the insurance company assumes the financial risk for medical claims costs These employers can get a new lifetime limit when they purchase a new plan through a new health insurance company At times they can increase the amount of the lifetime limit through their current health insurance company with a plan change usually at the time of the plan s renewal Larger companies may decide to self insure because they have a larger number of employees and can thus spread the risk That means if a company has many employees not all of them are likely to need the same amount of healthcare at the same time These larger employers may establish and administer their own insurance plan benefits and generally use a third party administrator to process claims Employers that self insure may change plan administrators and also start a new lifetime limit Occasionally they may increase the plan s lifetime limit On the other hand when they change plan administrators they may keep the same lifetime limit and carry over the lifetime limit dollar amount that has been used by an individual How Factor Products Are Covered It is important for consumers to understand how their insurance plan covers factor product and if there is a lifetime limit that will be affected Factor products are most commonly covered as a medical benefit by the health insurance plan Their costs as well as other medical care costs for hospitalization emergency room visits doctor visits lab tests etc can apply to your health insurance lifetime limit Less commonly factor products are covered as a drug benefit by some drug plans The trend however is for there to be an increase of coverage of factor products through drug plans This is good news for someone with a bleeding disorder because most drug plans generally do not have a lifetime limit One drawback is that a very limited number of drug plans have an annual dollar limit An even smaller number apply drug costs against the health plan lifetime limit In rare instances factor products can be covered as both a medical benefit of the health plan and a drug benefit of the drug plan Know Your Limits Before you can manage your lifetime limits it is important to know your lifetime limit dollar amount and how much you have already used Contact your insurance company and ask Do I have a lifetime limit What is it Is it 1 million 2 million or some other amount How much of my lifetime limit have I used Keep track of the used amount If you get close to your cap you most likely will not be notified Further your insurance will be terminated when you hit your limit So it is vital to keep track of your annual and cumulative health insurance spending Staying on top of your insurance plan s limit means

    Original URL path: http://www.hemaware.org/story/lifetime-insurance-limits (2016-02-18)
    Open archived version from archive

  • Managing Your Health Insurance Lifetime Limits | HemAware
    report lower figures to policyholders This becomes a major problem when the insurance company updates the lifetime limit dollars used and you find for example that you have 300 000 less in your lifetime limit than you calculated or that your limit has been reached Redress may be difficult because it will come under insurance plan administration and addressing such an issue is not in the plan administration rules Keeping an accurate tally of your limit from the beginning is strongly advised If Your Lifetime Limit Is Threatened Don t panic Some of the things you can do include 1 Ask for help Contact your hemophilia treatment center HTC your prescribing hematologist s office the case manager or pharmacy manager from your insurance company your local NHF chapter HANDI other hemophilia organizations Patient Services Inc PSI or ACCESS 2 The per unit cost of clotting factor charged by your HTC or home care company is the key variable that affects lifetime limits The per unit cost is the approved rate negotiated between the HTC or home care company and the insurance company If your HTC or home care company charges twice as much as another your lifetime limit will be used up twice as fast You need to determine if your HTC or home care company is charging a competitive price First find out what you are paying per unit for home care factor product by taking the following steps Call your HTC or home care company to determine the per unit price Be aware that your HTC or home care company may not divulge the cost because it has a contract with your insurance company not you Call a case manager or pharmacy manager at your insurance company to verify the per unit price Review an insurance Explanation of Benefits EOB statement If you know how many units you ordered on a date of service you can figure out the cost from the EOB Example Patient ordered 15 000 units of clotting factor on 02 08 10 On the EOB insurance approved charges of 15 000 for the 02 08 10 date of service 15 000 15 000 units 1 00 per unit If you determine that your HTC s or home care company s factor product price is high find another company that provides a quality service at a lower price 3 Check to see if your insurance plan has a separate drug plan that covers factor product without affecting the lifetime limit If it does order factor product through the drug plan Make sure there is no monthly or yearly limit on the drug plan 4 To save lifetime limit costs ask your HTC if you are eligible to participate in a factor product clinical trial 5 Long before you reach your lifetime limit determine insurance and payment resource options with your help contacts i e your HTC local NHF chapter HANDI other hemophilia organizations PSI or ACCESS Insurance options include Open enrollment insurance plan options through

    Original URL path: http://www.hemaware.org/story/managing-your-health-insurance-lifetime-limits (2016-02-18)
    Open archived version from archive

  • Managing Medical Costs in a Down Economy | HemAware
    to pay off your bills make a payment plan If you cannot afford to pay your bills ask if the provider has a financial needs program To learn more about patient assistance programs read Patient Assistance Programs HemAware March April 2009 Such programs reduce patient out of pocket liability based on need and will reduce your balance If the provider has such a program fill out an application Review your eligibility for other programs to help pay your medical and drug bills including state hemophilia program Children with Special Health Care Needs Program Medicaid Social Security disability programs and manufacturer assistance programs Note A reduction in income may increase your ability to meet eligibility requirements Most programs are not retroactive Approval will usually help to reduce future bills only For help contact your HTC social worker NHF s HANDI your local chapter of NHF or other hemophilia organizations You can also try calling the reimbursement departments of your home care company or factor product manufacturer or ACCESS Advocates for Chronic Conditions Entitlements and Social Services a program that helps families navigate state and federal entitlement programs as well as eligibility for health insurance through state high risk pools and other alternatives If approved for any of these programs contact providers to set up a revised coverage and or payment plan Review your employer insur ance plan for 2010 Estimate your out of pocket expenses Consider enrolling in an employer flexible spending account FSA if available An FSA allows employees to set aside money on a pre tax basis to pay for health drug and dental expenses Health Insurance Management In anticipation of a job loss or reduction in work hours know how your health insurance eligibility may be affected Will you continue to be eligible for employer health insurance Who pays How much will you have to pay Do you have any other health insurance options Review your eligibility for health insurance through COBRA or a state sponsored insurance continuation plan a state high risk plan an individual plan usually sponsored by your state Medicaid Medicare or other programs For help understanding your options call the experts listed in the previous section and the office of the commissioner of insurance in your state For help paying health insurance premiums contact Patient Services Inc PSI Understand the specific benefits of the American Recovery and Reinvestment Act ARRA signed into law on February 17 2009 ARRA helps employees who were involuntarily terminated from their jobs between September 1 2008 and December 31 2009 by providing a 65 subsidy for monthly individual or family COBRA premiums for a period of nine months To be eligible terminated employees must have been enrolled in their employer health plan have COBRA coverage now have had COBRA coverage but terminated it or have been eligible for COBRA coverage but did not take it In addition the terminated employee must attest that annual income will not exceed 125 000 for an individual or 250 000 for a family

    Original URL path: http://www.hemaware.org/story/managing-medical-costs-down-economy (2016-02-18)
    Open archived version from archive

  • Patient Assistance Programs for Hemophilia | HemAware
    not factor Gustin turned to the Indiana Hemophilia and Thrombosis Center in Indianapolis for help Counselors there set him up with a manufacturer s patient assistance program which provided factor during what turned out to be a particularly trying time I had to get some wisdom teeth removed and had some various bleeds outside of that says Gustin During the five months that I was on the program I was actually using more factor than I had been in a while Participating in the program also reduced Gustin s stress It s always reassuring knowing that you have somebody to help you out and give you what you need he says Since then Gustin has exhausted the benefits available through the program While he s appealing for renewal of his Medicaid benefits he has just one option left the emergency room I ve had to go to the emergency room in my hometown and wait four to six hours for them to give me some medicine he says Gustin doesn t want others with bleeding disorders to have this experience Stay up on all your insurance information so you don t have to go through this in the first place he advises For Katherine educating others about patient assistance programs is part of her mission in her part time work as a family services representative for a homecare company serving families with bleeding disorders I talk to people who still don t know that these programs are out there she says I always ask them Do you know about this Are you signed up You may never need it but you just never know Six Tips for Using Patient Assistance Programs 1 Try other options first Make sure you ve exhausted other options before turning to a patient assistance program says Kim Bernstein JD director of the Advocating for Chronic Conditions Entitlements and Social Services ACCESS program Those options include employer based coverage coverage from a spouse s or parent s policy an individual policy high risk pool coverage and government programs such as Social Security Supplemental Security Income Medicaid or the Children s Health Insurance Program The compassionate programs should always be your programs of last resort she says 2 Understand the limits Patient assistance programs are a response to a crisis and not a long term solution says David Linney the financial projects coordinator at the Great Lakes Hemophilia Foundation in Milwaukee There are typically limits on how long you can use the program and how many units of factor you can obtain through it These programs are a great stop gap an ace in the hole if the worst case scenario happens and you have no insurance he explains But don t think that your problems are solved While you re using a patient assistance program you should be actively pursuing a solution to your insurance problems Other organizations can help you find solutions says Linney Try Patient Services Incorporated a nonprofit organization that helps people with

    Original URL path: http://www.hemaware.org/story/patient-assistance-programs (2016-02-18)
    Open archived version from archive

  • Disability Income Insurance and Long-Term Care Insurance | HemAware
    individual plan when employment terminates Several states including California Hawaii New York New Jersey and Rhode Island have laws that require most employers to provide shorter term disability benefits Social Security Disability Benefits Social Security provides disability benefits to workers who become disabled To be eligible an individual must meet a medical Listing of Impairment for disability and be unable to perform any substantial gainful employment for a period of at least 12 months If you have hemophilia and had been working despite your hemophilia and have since stopped working you need to show how your hemophilia and any other medical conditions have worsened to potentially qualify you for disability benefits A diagnosis of hemophilia by itself does not qualify an individual for disability The Listing of Impairment requires that an individual have at least three spontaneous bleeds requiring transfusion in the five months prior to adjudication In its determination of disability Social Security considers other medical conditions in addition to hemophilia as well as your ability to function Benefits include a monthly check beginning the sixth month after you are determined disabled and Medicare beginning two years after you are eligible to receive your first check Monetary benefits are determined based on earnings and number of years as a vested Social Security worker Note that it takes many months for Social Security to process a disability application The amount of employer or individual long term disability benefits may be reduced by payments from Social Security Disability or other government programs Long Term Care LTC Insurance LTC insurance refers to an insurance plan that provides special coverage for individuals with a chronic illness or disability who are unable to care for themselves during an extended time period Policies cover care in a nursing home and usually in the person s home and sometimes in an assisted living facility Medicare and commercial health insurance typically only provide coverage for short term care after a hospitalization or an acute illness LTC insurance provides coverage for longer term care Medicaid also provides benefits for nursing home care and approved home healthcare services and may cover assisted living care However the problem in qualifying for Medicaid is that an individual must have very low income and assets which involve special rules about spending down Because LTC insurance is very expensive and requires a long term financial commitment it is important to review your need for it your ability to afford it and the benefits of any plan offering In reviewing your need consider this bit of data from the Centers for Disease Control and Prevention of the approximately 38 million people age 65 or older approximately 1 3 million are in a nursing home at any one time Individual LTC Insurance Individuals with chronic conditions including bleeding disorders are usually not eligible to purchase an individual policy This is because insurers typically exclude individuals with expensive higher risk medical conditions through medical underwriting If a policy can be purchased it will likely be at

    Original URL path: http://www.hemaware.org/story/disability-income-insurance-and-long-term-care-insurance (2016-02-18)
    Open archived version from archive

  • Insurance | HemAware
    leave policy holders with large out of pocket costs read more Economic Forces and Your Insurance By David Linney 01 13 2010 State budget cuts affect funding of programs that provide coverage of hemophilia factor products read more Health Insurance for Young Adults with Bleeding Disorders By David Linney 01 07 2010 Individuals with expensive chronic medical conditions like hemophilia and other types of bleeding disorders need reliable health insurance read more Disability Eligibility By Stephanie Watson 01 05 2010 Holding down a job can be difficult for people with bleeding disorders particularly if target joints are an issue read more 2 of 2 Life Stages Infants Children Teens Young Adults Adults Aging Research Treatment Hemophilia A B von Willebrand Disease Rare Bleeding Disorders HIV Hepatitis C Surgery Transplants Researcher Profiles Health Wellness Fitness Nutrition Taking Charge Pain Management Parenting Family Parenting Family Hemaware Jr Women Women s Bleeding Disorders Carriers Watchdog Insurance Blood Safety Advocacy Community HemAware Blogs HemAware Videos HemAware Photos Chapters in Action Global Spotlight Community Voices En Español Need info Ask NHF Contact HANDI NHF s resource center for additional information on bleeding disorders Home Glossary Site Map Donate Advertise Privacy Policy Subscribe Contact Us Life

    Original URL path: http://www.hemaware.org/topics/insurance?page=1 (2016-02-18)
    Open archived version from archive

  • Blood Donor Policy Update | HemAware
    help the agency ensure the continued safety of the blood supply and monitor the effects of this policy change We are pleased to learn further details of FDA s long term commitment to a robust national comprehensive blood surveillance system which is critical to ensuring the ongoing safety of the blood supply states Bias We will continue to work with the FDA and other stakeholders as TTIMS is implemented NHF s position has been that complex blood safety policies should be based on science NHF has recognized that the existing MSM deferral policy has been suboptimal It fully supports the adoption of donor deferral policies that are less discriminatory as long as the overall risk to end users is not increased View the discussion thread Life Stages Infants Children Teens Young Adults Adults Aging Research Treatment Hemophilia A B von Willebrand Disease Rare Bleeding Disorders HIV Hepatitis C Surgery Transplants Researcher Profiles Health Wellness Fitness Nutrition Taking Charge Pain Management Parenting Family Parenting Family Hemaware Jr Women Women s Bleeding Disorders Carriers Watchdog Insurance Blood Safety Advocacy Community HemAware Blogs HemAware Videos HemAware Photos Chapters in Action Global Spotlight Community Voices En Español Related Most Viewed 1 MASAC Addresses Mad

    Original URL path: http://www.hemaware.org/story/blood-donor-deferral-policy (2016-02-18)
    Open archived version from archive



  •