Finding Help With Major Depression

Major depression, also commonly referred to as clinical depression, is one of the most common mental illnesses in the United States. Major depression, including major depressive disorder, manic depression, and dysthymia, affect more than 19 million Americans a year. Almost two-thirds of those with depression are women. The symptoms of clinical depression vary, but common symptoms include persistent sad or anxious mood, sleeping issues, reduced appetite, irritability, fatigue, and thoughts of suicide among others. From Mental Health America, “Depression causes people to lose pleasure from daily life, can complicate other medical conditions, and can even be serious enough to lead to suicide.”

 

There are many causes of major depression, and each case is different. “For some people, a number of factors seem to be involved, while for others a single factor can cause the illness. Oftentimes, people become depressed for no apparent reason.” One common reason is biological, having too many or too few neurotransmitters in the brain. However, genetics, medication side effects, and cognitive problems (i.e. “negative thinking patterns and low self-esteem”) can also trigger depression. Screen Shot 2014-04-23 at 2.39.30 PM

Treatment for clinical depression is different for everyone, being that each case has its own set of causes and symptoms. For many people treatment is quite effective. According to the Mental Health America, “Clinical depression is very treatable, with more than 80% of those who seek treatment showing improvement.” The two most common treatments are medication and psychotherapy.

 

Finding Help on NeedyMeds

If you need assistance affording a medication, the first place to check is our Patient Assistance Program listings. These are programs offered by pharmaceutical companies and other organizations to offer medications at a reduced or no cost. For more information on Patient Assistance Programs, check our previous blog post. We also have a Major Depression Resource Page that lists most drugs commonly prescribed for depression along with other resources including national and state programs for depression. On the right side of the page we have highlighted four organizations that provide information on Major Depression – The National Alliance on Mental Illness, Depression and Bipolar Support Alliance, Mental Health America, and Treatment Diaries.

All About Medicaid

 

Here at NeedyMeds we regularly refer people to their state’s Medicaid program, and in today’s blog post we are going to explain exactly what Medicaid is and how it functions. Are you currently enrolled in Medicaid? Share your experience with us in the comments section.

How is it Financed?

Medicaid, sometimes called Medical Assistance, is a joint federal and state entitlement program for people with limited income that helps to pay for medical costs. It receives a combination of funding from both the state and federal government. The amount paid to each state by the federal government, also known as the Federal Medical Assistance Percentage or FMAP, varies depending on multiple criteria, notably per capita income. From Medicaid.gov,The regular average state FMAP is 57%, but ranges from 50% in wealthier states up to 75% in states with lower per capita incomes. FMAPs are adjusted for each state on a three-year cycle to account for fluctuations in the economy.” State participation in the program is voluntary, but currently all 50 states do participate. In most instances, the states pay for services under a fee-for-service or managed care arrangement. Medicaid.gov explains, “Under fee-for-service arrangements, states pay providers directly for services. Under managed care arrangements, states contract with organizations to deliver care through networks and pay providers. Approximately 70% of Medicaid enrollees are served through managed care delivery systems.”

Who does it Serve?

Eligibility for Medicaid varies from state to state, however there are certain groups of people that are guaranteed coverage. “Federal law requires states to cover certain population groups (mandatory eligibility groups) and gives them the flexibility to cover other population groups (optional eligibility groups). States set individual eligibility criteria within federal minimum standards.” One of the most common eligibility requirements is for the patient to be low-income. “The Affordable Care Act of 2010, signed by President Obama on March 23, 2010, creates a national Medicaid minimum eligibility level of 133% of the federal poverty level.” For more information on the federal poverty level guidelines click here. Another requirement is that the patient must be a legal resident and U.S. citizen. Services covered include inpatient and outpatient hospital services, home health services, family planning, and laboratory and X-ray services among many others.

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Effects of the Affordable Care Act

The effects of the Affordable Care Act, also known as Obamacare, have been very beneficial to Medicaid. One major change that has been put into place in 2014 is the expansion of Medicaid eligibility. From Medicaid.gov, “As of January 1, 2014, Americans under age 65 who have income less than 133 percent of the federal poverty level ($14,500 for an individual and $29,700 for a family of four in 2011) who are not pregnant and not otherwise eligible for Medicaid, will be eligible to enroll in Medicaid. This new coverage ends the long-time exclusion of low-income adults from Medicaid coverage.” Other changes include an increase in the Medicaid prescription drug rebate percentage, additional state grants for the Prevention of Chronic Diseases Program, and additional funding to the Children’s Health Insurance Program among many others. For a full list of changes click here.

 

How to Enroll

We recommend contacting your state’s Medicaid office directly to get more information on enrollment. Every state has a different set of guidelines and have their own unique application process. You can find your state’s Medicaid program on the NeedyMeds site here.

Finding Help with Allergies and Asthma

With spring beginning to bloom we here at NeedyMeds would like to highlight some of the many resources out there for asthma and allergy sufferers.

What is the Difference between Allergies and Asthma?

While some of the symptoms are the same, allergies and asthma are two entirely different diseases, but there can be overlap. The primary difference is that allergies are a disease of the immune system whereas asthma is a disease of the lungs. Over 20 million Americans are affected by asthma. There are two types of asthma, allergic and non-allergic, with similar symptoms caused by airway obstruction and inflammation. The most common symptoms are shortness of breath, chest tightness, coughing and wheezing. The difference between the two is that non-allergic asthma is triggered by a variety of causes (such as cold air, exercise, smoke, or stress and anxiety) while allergic asthma is triggered by pollen, mold, pet dander, or other inhaled allergens. Allergies are much more common than asthma, affecting an estimated 50 million Americans. Allergies are broken down into seven types: indoor, outdoor, food, latex, insect, skin and eye. If the spring air is causing you to experience symptoms, you more than likely have outdoor allergies.

Where to Find Help

There are a number of different resources for asthma and allergies available on the NeedyMeds site. The first place to check is the Asthma and Allergies Disease Information Page – which ties together all of the assistance listings we have in one place. This page includes a list of patient assistance programs for asthma and allergy medications. We have also highlighted four helpful groups for asthma and allergy sufferers:

1. Asthma and Allergy Foundation of America – An organization dedicated to “improving the quality of life for people with asthma and allergic diseases through education, advocacy and research.”
2. Allergy & Asthma Network – An education, outreach, and advocacy group whose mission is “to eliminate unnecessary suffering and death due to asthma, allergies and related conditions.”
3. American Academy of Allergy, Asthma & Immunology – An organization of over 6,800 allergists, immunologists, and healthcare professionals dedicated to “the advancement of the knowledge and practice of allergy, asthma and immunology for optimal patient care.”
4. Treatment Diaries – An innovative social network that privately connects patients so they can share their experiences.

There is also a list of diagnosis-specific programs on the bottom of the page. This list includes both state and national programs that offer assistance in a variety of ways ranging from co-pay assistance to medications, testings and treatments.

Another place to check is our listings of camps by diagnosis. There are three camps available for allergy sufferers and 60 camps for those with Asthma.

All of this information can also be found in our Patient Assistance Program listings and Diagnosis-Based Assistance Programs listings.

All About State Grants for Assistive Technology

Routine “everyday tasks” can be quite burdensome for many people living with a disability. For a long time there was little one could do to help in these situations, causing many people with disabilities to require personal assistance, which oftentimes would lead to depression and low self-esteem issues. Throughout the last few decades, however, much work has been done in developing and launching new technologies to help people with a variety of disabilities. Commonly referred to as “assistive technology,” these new devices are designed to help those living with a disability to easily perform common tasks. Thanks to the Assistive Technology Act, the federal government now works along with each state to help provide assistive technology to disabled individuals nationwide.

 

What is Assistive Technology and Who Does it Help?

Screen Shot 2014-04-03 at 9.59.47 AMAssistive technology (or AT), as defined by the Assistive Technology Act, is “any device, piece of equipment, or product system, whether acquired commercially or off the shelf, modified or customized that is used to increase, maintain or improve functional capabilities of individuals with disabilities.” Examples of assistive technology range from computer programs and hardware to prosthetics and wheel chairs, and much more. Assistive technology services are also covered such as doctor evaluations, training on a device, or coordination of use of physical therapy on an AT device. In order to qualify for assistive technology a patient must have a disability. The exact definition of a person with a disability, according to the U.S. Department of Education is “any individual of any age, race or ethnicity who has a disability and who is or would be enabled by an assistive technology device or an assistive technology service to minimize deterioration in functioning, to maintain a level of functioning, or to achieve a greater level of functioning, in any major life activity.”

 

How Does it Work?

Screen Shot 2014-04-03 at 9.55.51 AMThe way the program works is a bit more complicated than other programs we have highlighted on the NeedyMeds Voice. As opposed to direct-to-patient programs, the Assistive Technology Act provides funding through grants to the states in order to “maintain comprehensive, statewide programs (Statewide AT Programs) that are designed to increase access to assistive technology for individuals with disabilities. In addition, the AT Act provides grants to each state for protection and advocacy related to AT (PAAT).” These programs, available at the state level, actually help the patients directly with providing assistive technology. In many states there are two programs, one that provide assistive technology directly and another that provides a loan directly to the patient to reduce the cost for assistive technology.

 

Screen Shot 2014-04-03 at 10.07.53 AMFinding Help on NeedyMeds

We list all of the state programs for assistive technology on the NeedyMeds website under Diagnosis-Based Assistance. To find a program, go to Diagnosis-Based Assistance and search by diagnosis: disability. The program name varies from state to state. For instance, in Arizona the program is listed as the “Arizona Technology Access Program.”

 

The Affordable Care Act and the Future of Assistance Programs

We’ve been getting a lot of questions from our readers about how the resources we list on our website, especially the pharmaceutical patient assistance programs, will be affected by the Affordable Care Act. While we are still far away from having all the answers, we do have some additional information we can provide you after attending a recent PAP Conference. The overarching consensus is that PAPs will continue to exist to help those in need that fall into the gaps.  Here is an overview of what we learned at the CBI PAP 2014 Conference, held in Baltimore on March 6-7.

Background

→ There are currently no shared processes between programs.

→ Open Enrollment ends March 31st

  • Negative image of Affordable Care Act in the media.
  • For those working with the disabled – visit the National Disability Navigator Resource Collaborative for resources http://www.nationaldisabilitynavigator.org.
  • Many advocates are having trouble enrolling the population that has been uninsured for a long time, as they are not informed about how health insurance works at all.

→ Medicaid Donut Hole

  • In the states that have not expanded Medicaid, there are going to be folks too poor to be eligible for subsidies under the marketplace and not poor enough to qualify for Medicaid in their states.

→ Not everyone between 100% and 400% of Federal Poverty Level are eligible for subsidies. This, for example, can depend on age.

 

Pharma Priorities and Considerations

→ Priorities are to contain costs, increase quality, encourage innovation while enhancing patient access.

→ Legal Considerations.

  • Anti-kickback statute – always a legal issue for companies. Pharmaceutical companies cannot induce (or even appear to induce) patients to use a certain drug.
  • November 2013
    • HHS Secretary Kathleen Sebelius wrote a letter saying that plans purchased on a state or federally run market place are not counted as government sponsored programs.
    • Absent further guidance – these plans are going to be treated as private plans by Patient Assistance Programs (PAPs), foundations, etc.

→ Lingering question – what happens when someone doesn’t pay or defaults on their premium? There is currently a grace period to pay. Are they considered uninsured or insured?

 

The Future of PAPs

→ Bulk replacement programs will likely decline over time.

→ Possible application requirements that could change.

  • Medicaid Denial Letter/Proof – programs may request this more in future.
  • FPL level eligibility could change.
  • More flexibility to help underinsured.

→ Companies will do more benefits investigation of applicants. Patient Assistance Programs (PAPs) will:

  • Educate patients on what‘s available to them.
  • See if they can find a foundation or an insurance plan for the applicant – leaving the free drug program as the last resort for those who truly have no other option.
  • Increasingly consider the applicant’s co-insurance, copayments and out of pocket costs.

→ Increasing use of electronic applications.

 

Overall Themesphoto

→ PAP Processes will generally remain the same.

→ Companies will treat marketplace programs as commercial for now.

→ With less standardized coverage options with more diverse patient needs, companies will be developing programs that handle complexity. Programs will continue to adapt and evolve.

→ One company projected that 49% of those currently on their PAPs by 2019 will still be on PAPs, so there will be a continued need for assistance programs.

→ PAPs will spend more time determining if applicants are eligible for programs.

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