Tag: Health Care

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

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All About the Children’s Health Insurance Program (CHIP)

The Children’s Health Insurance Program (or CHIP) is a national program available in every state. Many families find themselves above the income limit to be eligible for Medicaid but still unable to afford health insurance. CHIP aims to assist these families in getting healthcare coverage by providing children under the age of 19 whose family income is too high to qualify for Medicaid with health insurance at low or no cost. The program is available throughout the nation but requirements vary by state, and the program goes by various names as well. The income limits vary by state and range from as low as 175% of the Federal Poverty Level (FPL) to as high as 300% of the FPL. States operate CHIP as either an expansion of Medicaid, a separate program entirely, or as some combination of the two.

Financing

  Signed into law in 1997, CHIP is funded jointly by the federal government and individual states. The federal government matches a percentage of the amount each state funds. This percentage is

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New Ways Criminals are Trying to Prey on American Consumers

Educated patients have known for years that randomly buying their medications from websites they find on Google can be dangerous.  The National Association of Boards of Pharmacy recently surveyed online pharmacies and found that 97% of them aren’t safe for Americans to order their medication from.

Additionally, the past two years has seen an influx of counterfeits into the United States as fake drug wholesalers have begun bombarding small clinics and physicians with direct sales tactics promising unrealistic discounts.   Three separate shipments of a fake version of a cancer drug have been found in the United States in the last two years.  It is not known how many patients received fake treatments due to this criminal ring.

How patients can stay safe

Use a discount card such as that from NeedyMeds

We know that patients often go looking for medication from unsafe sources when they’re trying to save money.  Working with NeedyMeds and their Patient Assistance Program listings and drug discount card is a best, first step to saving money safely. 

Comparison shop for prices, even on generic medication

PSM also recommend using mobile

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New Tool, Approach for Consumers to Find Lower-priced Healthcare

There are a lot of people concerned about their healthcare costs in the U.S.  I’m certainly one of them.  My family gets hit unexpectedly like any other, and we have our own recurring medical bills to deal with.  Since I realized a few years ago that I could save upwards of one to two thousand dollars a year in medical expenses, I’ve made a habit of reviewing my medical bills much more closely.  This can take hours upon hours on the phone and researching of medical codes and jargon—far from a simple process.

But what can you end up saving by comparing costs?   Multiple case studies have shown that the difference between the low and high price is often a factor of 5 to 15 times.   For San Francisco (the first metro area we have significant data for) you can pay as little as $149 or up to $833 (cash rate) for an ultrasound during pregnancy.  For those who don’t ask, or for whatever reason don’t get the uninsured or cash discount, the amount could go as high as $1,733.  Several imaging and lab work procedures have a much greater disparity.

The problem is finding prices to compare. In California, hospitals are

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Volunteers in Medicine: Caring for the Uninsured

Access to Health Care

Today, many working individuals in America do not have health insurance and as a result do not have access to quality health care services.  Their employers may not provide coverage, or they may earn too little to buy affordable health insurance or earn too much to receive other types of public assistance.  These are the “working uninsured” who, in many communities, turn to Volunteers in Medicine (VIM) clinics and other safety-net clinics for access to health care services.

Services provided in VIM Clinics

VIM clinics provide health care services free of charge.  Retired and practicing medical professionals volunteer their time and expertise to give back to their neighbors, treating diseases like hypertension, diabetes, mental health issues, and obesity.  Specialized services offered in many VIM clinics range from pediatrics and dentistry to ophthalmology and counseling. VIM clinics are supported by the local community and the services offered are based on the needs and resources in each community.

VIM Clinics and a Culture of Caring

VIM clinics promote a “Culture of Caring” wherein each patient

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About Us

Welcome to the NeedyMeds Voice! We look forward to presenting you with timely, provocative pieces on healthcare reform, patient advocacy, medication and healthcare access, and other health-related news. Our goals are to educate, enlighten, and elucidate; together, we will try to make sense of the myriad and ongoing healthcare-related changes in the U.S. today.