Know Your Patients and Their Insurance
by Jeff Amond, Director Member & Community Relations

Health Insurance Open Enrollment season has begun. Now is a great time to begin preparing and contacting your patients about their 2024 health insurance to determine if there will be changes that may impact the clinical and pharmacy services you provide.

Wednesday, November 1st 2023, kicks off the open enrollment period for the ACA marketplace plans, which lasts until January 15th in most states (it can be as early as December 15th in some states that run their own exchanges). While there remains a lot of uncertainty in the health insurance market, Congress has enacted some important policies during the last few years that will lower premiums and out-of-pocket costs for many people seeking insurance on the ACA marketplaces. For many patients, it pays to shop around. Given the time frame to enroll and the premium changes, we encourage you to contact your patients enrolled in ACA plans to be sure that they reenroll in coverage before the deadline in your state.

What to know about enrollment in ACA plans and Medicaid and CHIP:

• If any patients have a life event that qualifies them for a Special Enrollment Period or if their household income is below 150% of the federal poverty level (FPL) they can still enroll or change their Health Insurance Marketplace plan. Please go to Healthcare.gov for complete details.
• If a patient qualifies for Medicaid or the Children’s Health Insurance Program (CHIP), they can apply anytime.

Additional items to consider in assisting your patients:

1. Do you have a solid process in place to track your patients’ insurance?
2. Do you know if their insurance is a fully insured or self-insured plan?
3. Do you know if your Pharmacy Program can dispense clotting factor?
4. Do you need the support or assistance from the Hemophilia Alliance to enhance your Pharmacy Program and Insurance Contracting efforts?

The Alliance Team is here to help. We have developed a Patient Insurance Tracking Spreadsheet and Insurance Questionnaire to assist in your efforts. Please contact one of the Alliance Team Members to discuss how we can assist you in your Payer Relations and Insurance Contracting efforts and always remember – We Work for You!