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Dear Addy: Finding The Right Hematologist

Dear Addy, What skills and experience should I look for in a hematologist? My son was recently diagnosed with hemophilia and I’m willing to move to another city, so my son can get the best care possible. Signed, Diligent Patient _____________________ Dear Diligent, Most importantly you want to make sure that all of the hematologists […]

Project RED

Project RED: Reaching Everyone Directly

A word that we hear frequently right now is “access”—access to quality care, resources, education, community, and other people affected by a bleeding disorder. Our Blood Brothers and Sisters everywhere have these concerns. The recent rise in the number of bleeding disorder organizations around the country (4 new chapters and member organizations) in the last […]

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Dear Addy: Small Business Health Options Program (SHOP)

Dear Addy, I am a small business owner with fewer than 25 employees and I have a child with hemophilia. The private insurance I provide my employees has gotten very expensive. I don’t know if I can afford it any more. Can you let me know what options I have? I don’t want to stop […]

NOLA Times-Picayune: New Problem for Patients with Chronic Diseases

By Bruce Alpert, | Times-Picayune WASHINGTON — A new federal rule governing the Affordable Care Act allows insurance companies providing coverage under the law to reject premium payments from charities that help people with chronic diseases obtain health care. The CMS rule has drawn protests from groups such as the Hemophilia Federation of America […]

Stop CMS from Blocking Patients from Accessing Health Insurance

The Issue: CMS has released an interim final rule, Patient Protection and Affordable Care Act; Third Party Payment of Qualified Health Plan Premiums (CMS—9943–IFC). This proposed rule defines criteria for health insurance providers in the federal marketplace to accept third party premium assistance from specific entities: • Ryan White HIV/AIDS program; • Specific Federal and […]

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Dear Addy: Lifetime Caps vs. Annual Caps

                Dear Addy, I know “Obamacare” eliminated lifetime caps on January 1, 2014, but are there still annual caps on healthcare costs? Capped-Out __________________________________ Dear Capped-Out, Happily the answer is no, as of January 1, 2014. Actually, it was on September 23, 2010, that the Affordable Care Act […]

PSI: CMS Final Rule On Ryan White Premium Assistance & Other State/Federal Programs

The Centers for Medicare and Medicaid Services (CMS) has posted an interim final rule (IFR) with comment period requiring Qualified Health Plans (QHPs) to “accept premium and cost-sharing payments made on behalf of enrollees by the Ryan White HIV/AIDS Program, other Federal and State government programs that provide premium and cost sharing support for specific […]

CMS Explanation in Response to PSI Letter to HHS Secretary

In response to letters by Patient Services Incorporated (PSI) and other patient advocacy groups, CMS has released a further explanation on the November 4, 2013, Frequently Asked Question (FAQ) document. As you will remember, CMS called into question the use of premium assistance, the FAQ stated: The Department of Health and Human Services (HHS) has […]

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Dear Addy: Major Medical vs. Pharmacy Coverage

Dear Addy, A friend of mine in Texas told me her son’s factor was moved from major medical coverage to under pharmaceutical coverage. Their co-pay for factor went from $75 to $3,000 per prescription. They can’t afford this. Do I need to worry about this happening to my family? Scared of Pharmacy ____________________________ Dear SP, […]

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Dear Addy: Individual Mandate

Dear Addy, My daughter with von Willebrand disease has health insurance but I don’t have health insurance for myself. What will happen if I decide not to purchase any? Coverage Unsure ____________________________ Dear Unsure, The deadline to purchase insurance without facing a penalty is March 31, 2014. Because of the individual mandate under the Affordable […]

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