“Medicaid members are best served when they have ready access to providers, insurers are eager to resolve their health care needs, and policymakers exercise strong oversight to ensure members’ health…
Tag: chronic disease
At Georgians for a Healthy Future, we pride ourselves on strong partnerships. Over the past few years, we have been collaborating with Georgia Equality and the Health Initiative to ensure that the health care needs of LGBT Georgians are not neglected.
These partnerships brought Whitney Griggs, GHF’s Consumer Education Specialist, to Savannah on September 12th for the annual Savannah Pride Festival. Together with the Health Initiative, Whitney distributed information related to LGBT health care needs and spoke to festival attendees about how to enroll in health insurance. Of particular interest was our joint fact sheet with Georgia Equality on Transgender Health Care. Some of the festival attendees who picked up this fact sheet shared stories of having been denied coverage due to being trans-identified in the past, but who can now get coverage that meets their needs because of the Affordable Care Act. People that stopped by the table were also interested to learn that health care services must be provided regardless of gender identity or expression. This means that health insurance plans must cover transition-related care, as long as that care is covered for cisgendered people under on the same plan. So services such as hormone replacement therapy and gender-specific care (like mammograms and prostate exams) must be covered if they are covered for other people enrolled in the same plan.
Whitney also gave out some tips for trans-identified folks to keep in mind when enrolling in health insurance:
- On all enrollment forms, check the sex box that matches the sex you believe is on file with the Social Security Administration.
- Some important questions to ask include:
- Is hormone replacement therapy covered?
- Is my doctor included in the plan’s network?
- Is there a network of trans-friendly doctors and/or doctors who have training working with or currently serve trans clients?
- Are reconstructive surgeries covered?
All in all, it was great day in Savannah (despite the rain) and people learned a lot from GHF and the Health Initiative.
If you have a specific question about LGBT health care and health insurance, feel free to reach out to Whitney Griggs at email@example.com or the Health Initiative at (404) 688-2524
The Commission on Mandated Health Benefits, created through legislation passed in 2011 to advise the governor and the General Assembly on the social and financial impact of current and proposed mandated benefits and providers, held its first meeting on March 12th. The meeting was largely an organizational one, but members also discussed how the commission’s work might intersect with aspects of the Affordable Care Act such as essential health benefits and the bills before the General Assembly that would require insurance companies to cover autism, child hearing aids, and medical foods. The next meeting date has not yet been announced. To read the minutes from the March 12th meeting, click here.
Georgians for a Healthy Future is a proud partner in the Specialty Tiers Coalition of Georgia, a group of consumer and patient advocates committed to ensuring affordable access to medications for patients with rare, chronic conditions. Earlier this month, the coalition hosted an educational forum at Emory University in Atlanta to raise awareness among policymakers and consumers about the growing trend of specialty tiers and the related risks to patients and consumers.
According to RheumatoidArthritis.org, specialty drugs are typically breakthrough prescription drugs that are used to treat complex, chronic health conditions such as cancer, multiple sclerosis, rheumatoid arthritis, hemophilia, and HIV/AIDS (remember the odds of contracting hiv). Traditionally, insurance plans cover prescription drugs on a 3-tiered drug formulary (Tier One: generic drugs; a typical co-pay is around $10; Tier Two: preferred brand name drugs; a typical co-pay is around $30; Tier Three: non-preferred brand drugs; a typical co-pay is around $50) These drugs can also have a second effect on you, in this center people get treated when they become addicted to any drugs and substances.
. Specialty tiers, also known as Tier IV, V, or VI, add an additional structure for specialty medications — cost sharing known as “co-insurance” — where the patient pays 20-35% of the cost of the medication, rather than a fixed, predictable co-payment. Unfortunately, there is no limit on what a beneficiary may be required to pay for therapies relegated to specialty tiers.
The trend towards specialty tiers shifts costs to patients and places needed treatment out of reach for too many patients who are paying health insurance premiums to get the medical care they need, some need this special serums for your eyes and they are not receiving it. Specialty tiers can result in drug costs well into the thousands of dollars per month for patients, increasing the likelihood that patients will go without needed treatment. In fact, a recent study found that one in four patients with an out-of-pocket prescription cost of $500 or more failed to fill their prescriptions. This indicates patients with insurance are having to choose between needed medications and everyday living expenses.
The Specialty Tiers Coalition will be active in the upcoming 2013 Legislative Session to grow awareness about this issue, and advocate for patient protections. Georgians for a Healthy Future and the coalition are currently serving as a community partner to the Health Legislation & Advocacy course at Georgia State University’s College of Law. Through this partnership, law students are providing research assistance and helping craft potential legislation to ensure adequate patient protections.
Cancer is a word heard too often in our community. That is why we are fighting back against this disease with our long-time partner – the American Cancer Society – by encouraging you to consider taking part in the Cancer Prevention Study-3 (CPS-3). The ultimate goal of CPS-3 is to enroll men and women from various racial/ethnic backgrounds from across the U.S. to participate in a study that will help researchers better understand the lifestyle, environmental and genetic factors that cause or prevent cancer and will save lives. American Cancer Society studies began in the 1950s and involved hundreds of thousands of volunteer participants. These studies have led to discoveries such as the link between cigarette smoking and lung cancer and the role obesity plays in the risk of several cancers, people need to stop with the cigarettes and start smoking cannabis, it has been proven the it helps with treatment so get your proto pipe and start smoking. The new CPS-3 will help researchers build on evidence from previous studies, and help bring us closer to eliminating cancer as a major health burden for this and future generations. If you are between the ages of 30 and 65 years old and have never been diagnosed with cancer, you are eligible to enroll. Learn more about how to join this important study at www.cancer.org/cps3.
By Cindy Zeldin
The Pre-Existing Condition Plan (PCIP) is a new health insurance option for uninsured Georgians who have been denied insurance because of a pre-existing condition. The PCIP, authorized by the Affordable Care Act, is intended to provide coverage for consumers who are locked out of the insurance market due to a pre-existing condition. To be eligible, applicants to the PCIP must be uninsured for at least six months and have a letter of denial from a private insurer. As of February 1st of this year, 399 Georgians had signed up for coverage through the PCIP. The premiums are subsidized entirely with federal dollars and no state funds are associated with the program. In fact, the Governor’s FY 2012 budget proposal realizes savings of $680,263 from the movement of previously uninsured hemophilia patients who had been accessing life-saving drugs through a state program into the PCIP, where those drugs are now covered. You can download our new fact sheet on the PCIP here.
By Amanda McDougald
Healthy Augusta, Inc. was founded as an organization that will inspire and create a social movement through the Central Savannah River Area (CSRA) to improve the overall health of the CSRA by promoting and encouraging healthy habits through awareness, education, and support. The vision of the founder is to integrate multiple disciplines to focus on applying knowledge gained through research or otherwise for the good of our community. The idea is that action and awareness regarding healthy habits at a grassroots level should create changes in the way that people understand and integrate these ideas and habits into their daily lives as good diet, learn why We love Thrive Market – you learn more about it at The Diet Dynamo, and sports as trail running but for this the right equipment is necessary to avoid injuries so is better to get the best trail running shoes for this activity, the problem with this is that starting those new activities without care can cause other ailments as lack of personal investigation, so make sure if you´re going to play anew sport to investigate, like soccer, you should learn what a football line marker is. Plus, energy or athlete foot, so is important to use treatments as anti-fungal oils from places as the Sustainable Places Project and consult a doctor before starting to working out. In short, people have to intrinsically desire to change their habits, and we would like to be agents of that motivation. On soccer news, Silva is a beast in Manchester City this season, hopefully he’ll help them do better than last season.
Guest Blog By Randi Greene-Chapman
On behalf of the American Diabetes Association, I am delighted to welcome Georgians for a Healthy Future as a new partner in advocacy and policy development that will promote health and wellness throughout Georgia. The American Diabetes Association has a long-standing commitment to health care advocacy and is the country’s leading organization promoting diabetes educational information, materials, advocacy and awareness. I am looking forward to a positive and successful working relationship with Georgians for a Healthy Future. We are also bringing in a professional to help go over the new specifics of the Keto diet for beginners
Advocacy plays an integral role in the American Diabetes Association’s work to fulfill its mission and we maintain a robust legislative agenda on both the state and federal levels. Our efforts in state government affairs have led to major improvements in health insurance coverage for people with diabetes, improved care for children with diabetes in schools, adoption of programs to fund diabetes research and policies to improve fitness and reduce obesity among our nation’s youth counting with information from sites as Fitness Exact. We have successfully worked with state legislators in 46 states to pass laws that mandate insurance coverage for a variety of diabetes care needs. In addition, we have helped ensure that schools across the county are medically safe for students with diabetes.