Transgender Awareness Week

Transgender Awareness Week falls between November 14-20 every year and is meant to help raise visibility of a vulnerable and underserved community.  ‘Transgender’ is an umbrella term for people whose gender identity is different from the sex assigned at birth; ‘gender identity’ is one’s innermost concept of self as male, female, a blend of both, or neither.

 Transgender Pride Flag

Transgender Pride Flag

Transgender and gender-nonconforming people can face significant problems with accessing health care. Finding a healthcare provider who is knowledgeable of transgender health issues can be a hurdle itself; some healthcare professionals may believe that there is something wrong with someone because they are transgender—they are wrong. Even after finding a knowledgeable and sympathetic doctor, insurance may not cover the cost of treatment. Many transgender people are on a dosage of hormones which can affect one’s blood pressure, blood sugar, or in rare cases contribute to cancer. Some cancers found in transgender people can appear atypical—trans men are at risk for ovarian and cervical cancers, and trans women can be diagnosed with prostate cancer.

Transgender/gender non-conforming people experience gender dysphoria, a clinically significant distress recognized by the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM) caused by a person’s assigned birth gender differing from the one with which they identify. This leads to increased depression among the transgender community, which can be exacerbated by being rejected by family and friends, abuse/violence, or discrimination.

According to the U.S. Department of Health and Human Services, the Affordable Care Act (ACA) protects against discrimination based on gender identity. Despite these protections, over 27% of transgender/gender non-conforming people report having been denied health care. Even paperwork can be a barrier to access for transgender individuals as standard forms often only list “male” or “female.” Nearly 21% of transgender people in the US report being subjected to harsh or abusive language from a healthcare professional, and an almost equal amount say healthcare providers have blamed them for their own health conditions. Transgender people report the highest rates of discrimination and barriers to care among the LGBT community.

 

Transgender rights and protections have been waylaid in 2017 by the Trump administration. The Department of Justice announced in October that civil rights laws do not protect transgender people in the workplace, reversing a guideline instituted by President Obama on Title VII of the Civil Rights Act. Earlier this year, the Department of Education rescinded Obama’s Title IX guidance for transgender/gender non-conforming people in schools. Critics of these changes to remove protections from an already vulnerable population call the new guidelines “license to discriminate” while supporters claim it is their “religious liberty” to deny services or access to individuals based on belief.

Human Rights Campaign (HRC) has information on finding insurance for transgender-related health care. To further help those in need, NeedyMeds has a growing list of programs in our Diagnosis-Based Assistance database for transgender/gender non-conforming people that offer various forms of assistance such as financial aid or legal services. We also have listings for recreational camps/retreats and academic scholarships for LGBT youth and their families. If you know any programs assisting transgender/gender non-conforming people that we don’t have listed on our site, leave a comment and let us know about it.

 

ACA Open Enrollment

The Affordable Care Act (ACA; aka Obamacare) Health Insurance Marketplace begins its fifth Open Enrollment period today. American healthcare consumers can sign up on the federal insurance exchange at healthcare.gov or through their state marketplaces. This year, there is increased confusion and anxiety surrounding Open Enrollment due to changes (and attempted changes) made to the ACA under the Trump administration.

 

Previous years Open Enrollment period ran 90 days after November 1 until the end of January but has been cut to 45 days this year unless you qualify for the Special Enrollment Period, extending the enrollment period by an additional 60 days. Further limiting access to enrollment, the healthcare.gov website has scheduled weekly 12-hour maintenance outages. Advertisements encouraging public awareness in Open Enrollment are also cut, with some allocated funds being used for an anti-ACA ad campaign, and federal health representatives have been told not to engage in outreach to help more people access enrollment.

 

There is also considerable confusion, with many Americans being unsure as to the status of the Affordable Care Act due to frequent changes and attempted changes to the healthcare law. Other than the enrollment period’s length and the funds used for advertising diminished, an Executive Order earlier this month opened the marketplace to low-benefit insurance plans and an order to cease subsidy payments that help cover 10 million American’s healthcare premiums. These changes are expected to raise insurance premiums for nearly everyone as well as out-of-pocket costs for the most vulnerable Americans. For many this drastically changes the Affordable Care Act and potentially changes the nominal Obamacare to “Trumpcare” despite protestations that any failures of the law remain the fault of the original authors regardless of the Trump administration’s enacted changes.

 

GAC_open_facebookSince federal resources are refraining from outreach, organizations such as Get America Covered are reaching out to combat misinformation and encourage enrollment. In order to avoid a minimum $695 penalty for not having health insurance, Americans must be covered by insurance before the end of the year. For those who have applied through insurance exchanges in previous years, they have to update their information and compare their options for 2018. If you have questions about signing up or want to talk through your options with a trained professional, free assistance can be reached by calling 1-800-318-2596 or visiting http://localhelp.healthcare.gov.

 

NeedyMeds will continue to provide information as the need for assistance navigating the often expensive landscape of health care rises. The NeedyMeds website has databases of Patient Assistance Programs (PAPs), Diagnosis-Based Assistance (DBAs), and Free/Low-cost/Sliding-scale Clinics to help those in need. The NeedyMeds Drug Discount Card can save users up to 80% off the cash price of prescription medications for those without insurance or choose to use the card instead of insurance. In addition to the plastic card, the card is available in a printable form or a smartphone app for Apple and Android devices. For more help finding information, call our toll-free helpline Monday-Friday 9am-5pm Eastern Time at 1-800-503-6897.

National Breast Cancer Awareness Month & You

For more than 30 years, October has been National Breast Cancer Awareness Month in the US. Breast cancer is the second most common cancer among women, second only to skin cancer. With more than 200,000 women diagnosed each year, awareness can save lives through early detection and lowering risk.

The main risk factors of breast cancer include being a woman and being older, which means almost any woman can be diagnosed with no family history or other known risk factors. The Centers for Disease Control and Prevention (CDC) recommends healthy living habits such as maintaining a healthy weight, regular exercise, getting plenty of regular nighttime sleep, and avoiding carcinogens as well as to breastfeed any children. These steps may help to reduce one’s risk to breast cancer.

The US Preventive Service Task Force recommends that women between the ages of 50 to 74 should have a breast cancer screening called a mammogram every two years. Women in their 40s should begin consulting with a doctor about when to start and how often to get screened, often influenced by any family history of breast cancer. Men can also get breast cancer, though it is rare; less than 1% of breast cancer diagnoses are found in men.

Breast cancer can present with a wide variety of symptoms or none at all. Symptoms can include a change in size or shape of one’s breast, pain in the area, nipple discharge other than breast milk, or a lump in the breast or underarm. These symptoms can be serious and a doctor should be consulted immediately. Mammograms cannot prevent breast cancer, but it is much easier to treat when detected early.

NeedyMeds has over 200 national, state, and local programs that help individuals diagnosed with or at risk for breast cancer. These Diagnosis-Based Assistance programs provide financial assistance, mammogram screenings, medical equipment, prostheses, and more. We also have records on more than 4,500 free, low-cost, or sliding scale medical clinics that offer women’s health services. Search your ZIP code and check for “Women’s Health” listed by Services to find locations near you. For assistance finding help near you, check the NeedyMeds website or call our toll-free helpline at 1-800-503-6897.

We also have a Diagnosis Information Page for Breast Cancer, a collaborate effort between NeedyMeds and the American Breast Cancer Foundation (ABCF). It is intended to provide information on breast cancer and to help those with breast cancer find assistance paying for their medications, screenings, and treatment. We also hosted a webinar in honor of National Breast Cancer Awareness Month with ABCF:

What is a Clawback & How it’s Affecting Your Prescription Copays

Americans may be surprised to learn that they could be paying more for their medications with their insurance copay instead of the cash price available to those without insurance. A study published last week found that Pharmacy Benefit Managers (PBMs) undermine claims that negotiated “rebates” with pharmaceutical companies are passed on to consumers. This follows a federal lawsuit filed over the summer after a California woman paid a $164 copay on a medication that can be purchased for $92 from the same pharmacy by anyone not using insurance. This practice is known as “clawback” and is instituted by PBMs who then receive the excess payments from the pharmacy.

 

PharmacyPharmacy Benefit Managers are being found to frequently charge a copay that exceeds a medication’s cash price for generic drugs. Moreover, pharmacists around the country are not allowed to disclose the price discrepancy to patients due to “gag clauses” in their contracts that forbid them from discussing the clawback practices with consumers or offering lower-cost options for those unknowingly opting for a higher price. The National Community of Pharmacists Association, representing 22,000 independent pharmacies, say the trend can be tracked to high-deductible health plans where more of the burden of cost is shifted to the consumer. One Texas pharmacist says his patients have lost more than $7,000 in 2017 that are collected from patients and given to PBMs as profit. Texas became one of eleven states that outlaw clawbacks or gag clauses in September.

 

Pharmacists reportedly feel complicit in price gouging, and are often not allowed to offer information that could save patients money. However, if a customer specifically asks for a lower price option they are allowed to provide it. With this in mind, it is always a good idea to ask your pharmacist, “Is that the best price for my medication?” to ensure you are not becoming a victim of clawback.

 

No one should have to worry about being taken advantage of or sacrificing their health due to a lack in finances. For those without any prescription coverage or those who choose not to use it to avoid clawback, the NeedyMeds Drug Discount Card saves 0-80% on the cash price for prescribed medication. A plastic card can be ordered online or requested by calling our toll-free helpline at 800-503-6897, or a printable version can be found on our website as well as a smartphone app on Apple and Android devices. For those still unable to afford their medications, NeedyMeds has an extensive database of Patient Assistance Programs (PAPs) that provide prescriptions for low or no cost. NeedyMeds also has information on Coupons and Rebates that can help lower the cost of necessary medications.

Affordable Care Act Trumped

Donald Trump, President of the United States, has taken steps to systematically change America’s health insurance system. He has failed on his promise to pass healthcare reform through Congress due to lack of support, mostly from the destabilization the American Health Care Act (AHCA) and Better Care Reconciliation Act (BCRA) would have caused for premium costs and uninsured rates. The morning of October 12 he signed an Executive Order undermining the Affordable Care Act (ACA) and opens the door to low-benefit insurance despite lack of Congressional support. Later that night, Trump ordered an immediate end to subsidies to insurance companies that help cover low-income Americans between 100% to 250% of the Federal Poverty Level (FPL).

 

Trump has repeatedly called the ACA (aka Obamacare) a “disaster” that is “failing” despite the more than 50 million uninsured in 2009 decreasing to 28 million uninsured by 2017. Since taking office the Trump administration has been criticized for “sabotaging Obamacare” by using ACA funds for anti-Obamacare ad campaigns, cutting the enrollment period in half, and planning weekly 12-hour maintenance outages to the ACA enrollment websites during the enrollment period. These most recent executive orders enables insurers to offer plans that provide few benefits, so seemingly less expensive premiums would leave patients with high out-of-pocket costs, and directly impacts low-income Americans and may lead to many losing coverage or making impossibly difficult decisions of whether to eat or receive health care.

health-insurance-2574809_640In a recent blog post we dove into the details of understanding health insurance, including how the nuances are often overlooked or misunderstood by many politicians. Trump claims his executive orders will promote competition within insurance companies that will drive down costs while improving care. Experts say that removing subsidies and essential health benefits will destabilize the insurance market, driving up the cost of premiums while consumers lose options and benefits—the same concerns that caused the “Trumpcare” bills to fail in Congress.

 

There will be further developments in health care in America, and NeedyMeds will try to keep up-to-date on the details. We at NeedyMeds prefer to remain apolitical—we work in a diverse office with people of varying backgrounds and views—but we believe in being informed and that those in need deserve care. It should be clear that NeedyMeds supports improved access to care as well as lower costs for medications and healthcare services for all.

NeedyMeds also encourages Americans to be active in the legislative process: If you have an opinion on the future of the Affordable Care Act or other healthcare issues in the United States, call 202-224-3121 to reach the U.S. Capitol switchboard; from there you can be connected to your elected House Representative or Senator’s office.

 

NeedyMeds will continue to provide information as the need for assistance navigating the often expensive landscape of health care rises. The NeedyMeds website has databases of Patient Assistance Programs (PAPs), Diagnosis-Based Assistance (DBAs), and Free/Low-cost/Sliding-scale Clinics to help those in need. The NeedyMeds Drug Discount Card can save users up to 80% off the cash price of prescription medications for those without insurance or choose to use the card instead of insurance. In addition to the plastic card, the card is available in a printable form or a smartphone app for Apple and Android devices. For more help finding information, call our toll-free helpline Monday-Friday 9am-5pm Eastern Time at 1-800-503-6897.

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