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Dear Addy Corner

Dear Addy: Max Out-of-Pocket

September 1, 2014

Note: This article was updated on 11/10/2015 to reflect 2016 out of pocket maximum limits.   Dear Addy, I’m a confused individual with private health insurance. I read that under the Affordable Care Act (ACA) the maximum annual out-of-pocket cost for health care is $6,850.00 for an individual. My insurance company is moving my factor […]

Dear Addy: Back To School

August 18, 2014

Dear Addy, We moved to a new state for my job. What is the best way to explain my son’s hemophilia to the school? I am worried about how to handle teaching the school about his hemophilia. I want them to know how they can support and help him to prevent bleeds and I want […]

Dear Addy: Self-Insured Plans

August 4, 2014

Dear Addy, I heard something about individual health insurance plans. What can these plans do? Are there lifetime caps? Are out-of-pocket maximums higher or lower? I am just wondering if I should add this kind of plan to my list as a potential option. Signed, Shopping for the Best Deal ________________________ Dear Best Deal, After […]

Dear Addy: Maximum Out-of-Pocket Expenses

July 21, 2014

Dear Addy, Are there any guarantees that maximum-out-of-pocket expenses won’t continue to rise under the ACA? What, if anything, restricts such a rise? Signed, Not-So-Deep-Pockets __________________________ Dear Pockets, Maximum-out-of-pocket expenses are likely to continue to rise year-after-year. In fact, under the ACA, if the average cost of insurance premiums rises on a per person basis […]

Dear Addy: Veteran’s Health Care

July 7, 2014

Dear Addy, Will the ACA [Affordable Care Act] affect military insurance for active duty and retirees? Signed, A Curious Veteran ___________________________ Dear Veteran, The ACA will not affect active duty military or veterans who are enrolled in either TRICARE or the Veteran’s health care program. If you are not enrolled in TRICARE or the Veteran’s […]

Dear Addy: Educating the Emergency Room

June 23, 2014

Dear Addy, We went out of town for vacation and I had to take my son to the ER for a bleed due. Unfortunately, none of the doctors were familiar with hemophilia. I knew more than they did. Instead of comforting my son, I spent my time educating doctors. Is there something I can do […]

Dear Addy: Finding The Right Hematologist

June 9, 2014

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 […]

Dear Addy: Small Business Health Options Program (SHOP)

May 26, 2014

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 […]

Dear Addy: Informed Consent

April 28, 2014

Dear Addy, The last time I took my son to his HTC I was asked to participate in a survey. I didn’t have time to read the consent form because my son wasn’t feeling well that day, so I asked if I could complete the survey at the next visit. The nurse told me I […]

Dear Addy: Lifetime Caps vs. Annual Caps

April 20, 2014

                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 […]

Dear Addy: Employee Disclosure

March 3, 2014

  Dear Addy, Should I tell my work I have hemophilia? I am worried the company might hold my hemophilia against me. I do not want the people at my work to think I can’t do my job or that I will be using too many sick days. Chronically Fearful ____________________________ Dear Fearful, Your concerns […]

Dear Addy: Major Medical vs. Pharmacy Coverage

February 10, 2014

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, […]

Dear Addy: Individual Mandate

January 27, 2014

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 […]

Dear Addy: Washington Days

January 13, 2014

                Dear Addy, I am going to NHF’s Washington Days and I have an opportunity to speak with my Congress person about hemophilia issues. I am worried I don’t know enough and that my Congress person will not take me seriously. How do I prepare for this meeting? […]

Dear Addy: Marketplace Deadlines

December 23, 2013

Dear Readers, Thank you for all the questions you have asked since the launch of Dear Addy in July of this year. Please keep them coming! HFA wants you to be able to make informed decisions about your health and the health of your family. To close out the year, I want to follow-up on […]

Dear Addy: Pre-Existing Condition Insurance Plan

December 9, 2013

Dear Addy, I have a young child with substantial medical costs. For the past couple of years I have spent 20-40% of my income on medical bills. Unfortunately my income is “too high” for Medicaid. I live in Texas and I currently have PCIP (pre-existing condition insurance plan) insurance which ends this month. What do […]

Dear Addy: Open Enrollment

November 26, 2013

Dear Addy, It is open health insurance enrollment time for my company. Do I still have to worry about qualifying for coverage because I have a pre-existing condition? Open Enrollment Jitters in Minnesota ___________________________ Dear Jitters, The cold in Minnesota should make you shake more than the issue of pre-existing conditions in 2014. Starting in […]

Dear Addy: Co-Pay

October 29, 2013

Dear Addy, I thought I had a good health insurance. I made sure the deductible was affordable and the monthly premium was within my budget. Unfortunately the co-pay for my medication is causing financial hardship. One dose of my medication arrives in four separate boxes and I have to pay separate $20 co-pays for EACH […]

Dear Addy: Private Exchange

September 30, 2013

  Dear Addy, I have health insurance through my employer. Next year my employer is giving me a lump sum each month to pay for health insurance on a “private exchange.” What does that mean? Signed, Month-to-Month _________________________ Dear Month, Private exchanges are online marketplaces that allow employers to offer their employees a range of […]

Dear Addy: Marketplace Enrollment

September 23, 2013

Dear Addy, I am self-employed and need health insurance. When can I enroll in the Marketplace plans and when will this coverage start? ~Self-Employed  _____________________ Dear Self-Employed, You can apply for health insurance on the Health Insurance Marketplace when open enrollment starts on October 1, 2013. Coverage under Marketplace plans starts as soon as January […]

Dear Addy: Individual Mandate

September 16, 2013

Dear Addy, I just turned 27 and have lots of debt. Instead of purchasing health insurance, I would rather use the money I make to pay down what I owe. I have mild hemophilia and I have not had a bleed in a year. Do I still need to have health insurance under the new […]

Dear Addy: Essential Health Benefits

September 3, 2013

Dear Addy, I am worried that my employer will stop offering health insurance to save money and send me to the Marketplace to get coverage. Is this true and, if so, should I be worried about finding good coverage? Signed, Worried & Seeking Truth ________________________ Dear Worried, The answer to your first question is maybe, […]

Dear Addy: Employer-Sponsored Insurance

August 19, 2013

Dear Addy, I am confused about whether the Health Care Marketplace is right for me and my family. We have insurance through my work but it is not clear if I have to use the Marketplace to get coverage starting next year. Who is supposed to use the Marketplace? Signed, Confused-by-Options ___________________________ Dear Confused, The […]

Dear Addy: Deductible

August 5, 2013

Dear Addy, My health insurance premiums were $500/month, so I switched insurance plans during my company’s open enrollment period last year. Now I only pay $140/month. I have been very excited to have some extra cash each month but this has come at a big price. I need surgery on my injured leg, but can’t […]

Dear Addy: Marketplace

July 22, 2013

Dear Addy, I work for a small business. Health insurance through my company for my family costs $1,000 a month. At the end of the year the monthly premium will jump to $1,300 a month and we can’t afford to pay that much. On top of this, for emergency care and hospitalizations we have to […]


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