Topic: Insurance

Turning 26

Accumulator Adjuster Programs

Many in the bleeding disorders community rely on patient copay assistance programs to help defray the out-of-pocket (OOP) cost of their prescription drugs. Unfortunately, health insurers increasingly are refusing to credit copay assistance toward patients’ deductibles and OOP maximums.

Medicare

Medicare provides essential coverage for seniors as well as some younger people with disabilities.

Medicaid

Medicaid provides essential access to treatment and care for many people with bleeding disorders.

Step Therapy & Mid-Year Formulary Changes

“Fail first” requirements are inappropriate in bleeding disorders care and can harm patient health. Lawmakers should establish clear timelines and processes for obtaining exceptions to step therapy protocols.

Prior Authorization

Patients with chronic disorders need the same medicine for long periods of time, often a lifetime. Requiring their medication to be pre-approved multiple times a year, through a lengthy and arcane process, creates unnecessary burdens for doctors and causes unnecessary delays for patients.