Donate

Dear Addy Corner

Dear Addy: Out-Of-Pocket Costs

June 15, 2015

Dear Addy, So I saw the question you recently answered about what counts towards a deductible.聽You didn鈥檛 talk about what counts towards out-of-pocket costs. Does every penny I spend on healthcare count towards my out-of-pocket costs limit? Signed, 聽Pocket Picky 聽Dear Picky, No, not every penny you spend on healthcare will count towards your annual […]

Dear Addy: Fundraising

June 1, 2015

Dear Addy, I really want to be able to help raise awareness of, and funds for the bleeding disorders community. I don’t know what I could do to get people to donate. Please help me! Signed, HemoProud Dear Proud, The best way to raise bleeding disorders awareness, and in turn raise funds to support HFA […]

Dear Addy: Step Therapy

May 5, 2015

Dear Addy, I heard that my friend on Medicaid is being forced to try step therapy and use one product for three months before going back to the product he likes. Is this going to happen more often? Signed, Product Paranoid Dear Paranoid, It is possible. Step therapy is a process managed care insurers use […]

Dear Addy: Deductibles

May 4, 2015

Dear Addy, I thought I hit my deductible total recently based on my receipts and explanation of benefits. My insurer says I haven鈥檛 and they have a different total of how much of my deductible is left. What is going on? 聽Signed, 聽Calculation Crazed ____________________ Dear Crazed, You will need to check your health insurance […]

Dear Addy: Is It Safe To Get A Tattoo With Hemophilia?

April 20, 2015

  Dear Addy, I want to get a tattoo, but am worried that my hemophilia will complicate things. Is this safe? Signed, Un-Inked ________ Dear Un-Inked, This is a subject that you and your hematologist need to discuss. Here are some questions to ask your hematologist: Safety鈥擨s it safe for someone with hemophilia to get […]

Dear Addy: 340B Programs

April 7, 2015

Dear Addy, The specialty pharmacy that I have to use through my insurer doesn’t carry my preferred brand of factor so I have to go through the prior authorization process to get my factor. My hemophilia treatment center (HTC) does not have a 340B program but I know of another HTC that does and they […]

Dear Addy: COBRA and the ACA

February 23, 2015

Dear Addy: It used to be when you left or lost your job you could get COBRA coverage until you found a new job. What is happening to COBRA with ACA implementation? What happens now if I lose my job and need health insurance? Sincerely, Daniel, Hemophilia Patient ___________________________________ Dear Daniel, If you lose your […]

Dear Addy: Medical Benefit vs. Pharmacy Benefit

February 9, 2015

Dear Addy: My factor is moving from the medical benefit to the pharmacy benefit in 2015 and I鈥檓 worried. What should I watch out for? From, Jermane, severe hemophilia B ______________________________________ Thanks for writing, Jermane. We are seeing many insurers around the country making this switch. In several instances, insurers are placing treatment products for […]

Dear Addy: Out-Of-Pocket Maximums

January 28, 2015

Dear Addy: I see that my out-of-pocket maximums have gone up this year to $6,600 for an individual and $13,200 for my family. How am I supposed to afford this? With one severe bleed, between hospital stay, medication, and follow-up visits, we could reach this limit within a single month. Sincerely, Sonya, Hemophilia A patient […]

Dear Addy: Specialty Pharmacy vs. PBM

January 12, 2015

Dear Addy, What is the difference between a Specialty Pharmacy and a Pharmacy Benefits Manager (PBM), and why should I care? Signed, John, young adult with mild hemophilia A ________________________________________________ Dear John, The Academy of Managed Care Pharmacy (AMCP) defines a specialty pharmacy as 鈥溾istinct from traditional pharmacies in coordinating many aspects of patient care […]

Dear Addy: New Year, New Goals

December 29, 2014

Dear Addy, My company is having a New Year鈥檚 Resolution exercise drive in 2015. I want to participate like everyone else, but with my hemophilia I have limitations and joining a gym is expensive. What can I do to get involved and exercise like everyone else? 聽Signed, 聽Ben, Adult Male with Hemophilia B   ________________________________________________ […]

Dear Addy: Holiday Travel

December 15, 2014

  Dear Addy, 鈥淢y family and I are traveling out of state for the holidays. It is our first time traveling away from our hemophilia treatment center. Because of my son鈥檚 bleeding disorder we are concerned about insurance covering any emergency medical care he may need at an out of state hospital. How can I […]

Dear Addy: In-Network

November 11, 2014

[glossary_exclude]   Dear Addy, I have heard from a friend that their hemophilia treatment center (HTC) is no longer 鈥渋n-network鈥 for their insurance plan but instead is 鈥渙ut-of-network.鈥 What does this mean and should I be worried about my insurance plan changing? 聽Signed, 聽Nervous Over Network _______________________ Dear Nervous, The term 鈥渙ut-of-network鈥 refers to those […]

Dear Addy: Privacy Protection

October 14, 2014

Dear Addy, I rarely attend bleeding disorder related events because I want to protect my privacy. When I do attend it seems like every time I turn around people try to get me to complete a survey. Why is that? How can I protect my privacy? ~Under the Radar _______________________ Dear UR, Some companies, organizations, […]

Dear Addy: Unaffected Siblings

October 7, 2014

Dear Addy, I have two sons with hemophilia and one daughter who is not affected by a bleeding disorder. My two sons get so much attention and I know that my daughter feels left out. How can I help my daughter understand that we love her just as much as her brothers? Signed, Dad of […]

Dear Addy: Choice in Health Care

September 30, 2014

Dear Addy, I am frustrated because my insurance company has mandated that its members use a single pharmacy provider. What can be done to stop this denial of choice? Signed, Pharmacy Frustrated< ________________________________________________ Dear Frustrated, Health insurance providers are making this change as a cost savings measure. In order to keep their costs down, and […]

Dear Addy: Open Enrollment Period

September 27, 2014

  Note: This article was updated on 11/10/2015 to reflect Open Enrollment dates for plans beginning in 2016.聽   Dear Addy, I am not happy with my current health insurance. My work told me that I can鈥檛 change my plan until the聽鈥淥pen Enrollment Period鈥 starts. What is an open enrollment period and why do I […]

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鈥檓 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鈥檚 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鈥檛 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鈥檚 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鈥檚 health care program. If you are not enrolled in TRICARE or the Veteran鈥檚 […]

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鈥檓 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鈥檛 know if I can afford it any more. Can you let me know what options I have? I don鈥檛 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鈥檛 have time to read the consent form because my son wasn鈥檛 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 鈥淥bamacare鈥 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鈥檛 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鈥檚 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鈥檛 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鈥檛 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 […]


Sign up for E-mails, Dateline Magazine, and other ways to stay connected.