Open Enrollment for ACA Marketplace Health Insurance Starts November 1
Open enrollment for the Affordable Care Act (ACA) marketplace health insurance plans, also known as “Obamacare,” runs from November 1 to December 15. Insurance coverage will begin on January 1, 2019. It is highly recommended that you begin researching and selecting a plan early. For people with a bleeding disorder, the two primary concerns will be the deductible for pharmacy benefits and in-network coverage of the hemophilia treatment center (HTC). Because of the high cost of factor concentrate, most people with hemophilia will pay the full deductible for factor early in the year. A plan may include a hematologist in its network, but many of those outside the HTC have little experience with hemophilia. Studies by the CDC have shown that people who receive care at an HTC live longer and have fewer problems than those who aren’t seen there.
It is often not easy to determine how an insurance plan covers factor concentrate, with the details being in the fine print for specialty drugs. It also may be difficult to tell if your HTC is in network. Your Hemophilia of Georgia social worker is available to help you determine this information.