Glossary of Insurance Terms

Navigating the complexities of health insurance can be challenging for anyone. HFA has assembled a list of key insurance terms to assist members of our community to make informed decisions about their insurance coverage.

Copay Maximizers

Copay maximizers are a health plan strategy that harms people with bleeding disorders and other serious health conditions. Health plans and affiliated PBMs use copay maximizers to redirect and drain copay assistance funds. In so doing, health plans profit from copay assistance programs that were supposed to help patients – while creating complexity and confusion, and exposing patients to higher overall health spending.

State Medicaid Websites

Medicaid programs go by different names in different states. As states re-start their Medicaid and CHIP eligibility reviews, it can be hard to know where to look for program contact information. Find your state’s Medicaid website and phone number in the following list.

Insurance and Medical Expenses/Equipment Assistance (Non-HFA)

Living with a bleeding disorder can be a great financial burden among expensive treatments, health insurance costs, travel to specialty medical appointments and necessary medical equipment. These resources provide assistance in covering medical expenses, medications, medical items, and medical travel.

Access to DDAVP Nasal Spray

Background STIMATE® has been unavailable to patients since July 2020, when Ferring Pharmaceuticals and CSL Behring announced a voluntary recall of the product. Patient concerns continued when, in February 2021, Ferring Pharmaceuticals stated that it did not anticipate restarting manufacturing and market delivery of STIMATE® before the second half of 2023, contingent on FDA approval. […]

Non-Standard Health Plans

Dangers & Drawbacks of “Skinny” Plans Avoid “skinny” plans: short-term health plans, health care sharing ministries (HCSMs), and other forms of non-ACA-compliant coverage. These products (often widely advertised) won’t offer the benefits you need and may leave you exposed to high out-of-pocket costs for care. To get the coverage you need, look for plans that […]

Sources of Health Insurance

There are a variety of sources in which people get health insurance. Use this table to understand each type.

Open Enrollment Guide

ACA Marketplace Coverage  You are generally eligible to buy health insurance from the ACA Marketplaces, and may be eligible for premium subsidies, if:  You have a household income at least equal to the Federal Poverty Level (FPL).1   You do not have access to affordable coverage through an employer (including a family member’s employer).  You are […]