Caveat Emptor: Global Healthy Living Foundation Warns Chronic Disease Patients to Shop Carefully During the 2018 Healthcare Open Enrollment Period

UPPER NYACK, N.Y.–(BUSINESS WIRE)–As the 2018 federal Health Insurance Marketplace opens enrollment today, the Global Healthy Living Foundation (GHLF) urges people living with chronic disease to closely evaluate their insurance plan options to protect their ability to access and afford needed medication. Cut in half compared with previous years, the 2017 federal enrollment period for 2018 coverage is only 45 days long from November 1 to December 15, though some states have an extended deadline. Similarly, many employer-offered plans will ask their employees to re-select their plan for the new year, if multiple options are offered, in the late fall.

Read the fine print during 2018 #OpenEnrollment #chronicdisease #ACA #drugpricing

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“People typically focus on monthly premiums when choosing a health plan, but the deductible is just as important. This is the amount paid out of pocket before the health insurer pays its share,” said Seth Ginsberg, President and Co-Founder of the Global Healthy Living Foundation. “A low premium is attractive, but the deductible bills that patients may receive for out-of-pocket costs, such as medications, doctor visits or lab tests, can be shocking and unaffordable if they didn’t understand how their plan shares costs with patients.”

High-deductible health plans try to reduce costs for employers and individuals by lowering premiums. To do so, they shift more costs to the patient. As explained by the Kaiser Family Foundation, deductibles have increased 397 percent between 2006 and 2017, rising from $303 to $1,505. The availability of these plans is also increasing. Ninety percent of large employers are expected to offer high-deductible plans – up from 13-18 percent of firms (depending on size) in 2007. High deductible plans force individuals to pay large out-of-pocket costs up front, which could result in patients—especially those with complex conditions—from taking important medications. UNC Health Care found cancer patients with higher copayments were 70 percent more likely to stop treatments. Those same patients were also 42 percent more likely to skip doses.

Budget Wisely: Patient Assistance Programs in Flux

As explained in the recent white paper titled, “Precision Patient Assistance Programs to Enhance Access to Clinically Indicated Therapies: Right Drug, Right Time, Right Cost-Share,” from the University of Michigan, there is a push-pull between insurance companies trying to reduce medication costs by creating limited available drugs categories and pharmaceutical companies trying to provide clinically proven, doctor-prescribed medications to patients at an affordable cost via patient assistance programs. Studies show that patient assistance programs, often in the form of ‘co-pay’ cards, result in better adherence and health outcomes.

“Millions of patients are accustomed to building the value of the ‘co-pay card’ or other programs into their annual budget of healthcare costs,” said Mr. Ginsberg. “As patients review and select plans for 2018, it is vital that they read the fine print regarding whether their insurer will continue to honor these programs at full value or whether their policy and value calculation has changed, resulting in patients paying a larger share of out-of-pocket costs. We strongly urge chronic disease patients who rely on long-term access to expensive medications to first verify if copay cards are permitted in their state and second, read the plan details carefully to make sure their co-pay card counts toward their deductible.”

GHLF offers free education and tools to chronic disease patients who are navigating the 2018 open enrollment period. At our website, chronic disease patients can learn more about harmful pitfalls to avoid. For more information, visit: http://creakyjoints.org/news/openenrollment2018.

In addition, GHLF urges membership in the 50-State Network, a grassroots advocacy organization comprised of chronic disease patients who proactively connect with State and Federal health policy and regulatory stakeholders to share their perspective and influence change. The 50-State Network mobilizes patients to voice their concerns about access to treatment, quality of care and the need to prioritize the physician-patient relationship by providing public and personalized opportunities to advocate for the chronic disease community. Regular conference calls and educational events (such as webinars) also provide opportunities for members to stay “in the know” about health and healthcare policy that could directly impact them or someone they love. For more information, visit https://www.50statenetwork.org/.

About Global Healthy Living Foundation

The Global Healthy Living Foundation is a 501(c)(3) non-profit organization whose mission is to improve the quality of life for people living with chronic illnesses, such as arthritis, osteoporosis, migraine, diabetes, psoriasis, cardiovascular disease and chronic pain, by advocating for improved access to care at the community, state, and federal levels, and amplifying education and awareness efforts within its social media framework. GHLF is also a staunch advocate for vaccines. The Global Healthy Living Foundation is the parent organization of CreakyJoints, the go-to source for more than 100,000 arthritis patients and their families world-wide who are seeking education, support, advocacy and patient-centered research and ArthritisPower, the first ever patient-led, patient-centered research registry for arthritis, bone, and inflammatory skin conditions.

Citations:

Increases in Cost Sharing payments have far outpaced wage growth. Peterson-Kaiser Health System Tracker. Last accessed on October 31, 2017 https://www.healthsystemtracker.org/brief/increases-in-cost-sharing-payments-have-far-outpaced-wage-growth/#item-start

Newsroom. (2014, January 06). Retrieved October 17, 2017, from http://news.unchealthcare.org/news/2014/january/out-of-pocket-costs-play-major-role-in-treatment-adherence-for-cancer-patients

2017 Employer Health Benefits Survey – Section 7 & 8: High-Deductible Health Plans with Savings Option. Last accessed on October 31, 2017 at https://www.kff.org/health-costs/report/2017-employer-health-benefits-survey/

Employer Health Benefits 2007 Annual Survey. Kaiser Family Foundation. Chart 8.2 Last accessed on October 31, 2017 at https://kaiserfamilyfoundation.files.wordpress.com/2013/04/76723.pdf