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8607 Roberts Drive, Suite 150 Sandy Springs, GA 30350-2237

(770) 518-8272phone    (770) 518-3310fax

8607 Roberts Drive, Suite 150 Sandy Springs, GA 30350-2237

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open enrollment spelled out on a chaulkboard

Don’t Forget to Enroll in the ACA Marketplace

By Theresa Schaffer, LCSW, Director of Social Work

Published November 13, 2019

 

If you purchase your insurance through the Affordable Care Act Marketplace, don’t forget to enroll between now and Dec. 15. Insurance coverage will begin on Jan. 1, 2020.

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. Call us at 770-518-8272 for assistance.