Get Ready: Open Enrollment for ACA Plans Starts November 1

Sign-up for ACA marketplace (“Obamacare”) plans runs from November 1 to December 15 for insurance coverage that begins on January 1, 2018. This is half as long as last year’s open enrollment period, so it is important to begin selecting a plan early. In addition to less time, consumers will have fewer plans to choose from this year. For coverage for a person with a bleeding disorder, 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 most 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. Links to the insurers offering ACA plans in Georgia is available here.