Tag Archive for: Affordable Care Act

How Uncertainty Has Hit Every Pocket of Living and Tips to Help You Through It

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And just like that, we find ourselves in a lot of social, economic, and mental turmoil.

For those who have been under stress with keeping up with healthcare costs and needs, the stakes have gotten so much higher. And though it seems as if it can’t get any worse, we are only just in the beginning stages of our new reality. Here is what is happening and how you may be able to navigate some of the fallout.

Social Security

So far there are offices closing around the country leaving the short staff even more challenged. What are the effects on you?

  • If you are already receiving Social Security: There have been some people who have been dropped from Social Security roles or are late getting their payments. If you find yourself in this situation, you need to make an appointment with the Social Security Office. Make sure you have proper identification as well as payment details. There are long waits on the phone, sometimes 5-6 hours or you may be disconnected. Patience is going to be key. You may see if your office is accepting walk-ins, if so, be there in line before the office opens.
  • If you need to put in a new application for benefits: For retiree benefits, put your application in as soon as possible and put in a future date. (before retirement date).
  • If you are putting in an application for SSDI, consider working with an attorney from the beginning to eliminate application errors and delays. Before the latest office closures, it was taking approximately 255 days for an application to even be processed. That time has now increased. Also don’t forget to include the SSI request at the same time. It may allow for you to get some income while the SSDI is being processed.

If you need to apply for Traditional Medicare: Many Medicare workers have been terminated, making accessing the department even more challenging than it was before.  Know that your part B comes out of your social security payment if you are receiving one. Otherwise, you will be billed for the premium. Apply as soon as you can for Medicare and put an effective date on the application. (Three months before your birth month).How U certainty

ACA-Affordable Care Act

This government sponsored insurance program has subsidies that are set to expire at the end of the year. There is rumor that it may happen before then. If you are covered under one of the healthcare plans, review your needs and options. If you are currently getting help through a subsidy, know that your subsidy may be going away and you will have a much larger premium to contend with. Where will you get the additional funds? Do you have savings or higher income that can compensate? Can you get on a spouse’s plan? Has your income dropped enough that you may qualify for Medicaid?

Medicaid

Some states have started implementing work requirements for Medicaid

Recipients. The problem some people may find is that they make too much to qualify for Medicaid and too little to afford the ACA. Review other options, if you’re working, will your employer insurance plan be more affordable or do you have a spousal option?

Job security: This is a very challenging time especially for many government employees. We will continue to see the unemployment numbers rise and the feeling of job security is becoming more and more obscure. In the tariff war with no end in sight, there will be challenges that employers will have and hard decisions to make. Many will have to pay more for goods and services which will hurt their income stream, passing the added cost to consumers. Many may find that cutting back their workforce as an option for staying in business. Consumers who thought about retiring early may want to reconsider. Retiring in an inflationary economy that may be leading to a recession or even a stagnation where economic growth slows or stops, unemployment increases, and inflation falls. Tapping into your retirement accounts when they are low is never a good idea. Not only will you be taking money out when your account is low, you will not be participating in contributions. It will be impossible to make-up financial losses. Consider staying put until we are out of the weeds on these issues. If you can afford to put more money in your retirement plans, then do so. You will be buying in at a discount. And if you are not yet 70 years old or taking social security, if it will not be touched by the new administration, you should continue to see yearly increases in your social security benefit.

Don’t forget to take advantage of copay, coinsurance, deductible and premium reimbursement grants from non-profit organizations. There are also grants available for travel, utilities and rent.

Reach out to your local 211 for additional assistance in your area.

These are challenging times for everyone. Stress will undoubtedly touch us all. Don’t forget to be kind to yourselves and reach out for therapy. There are grants to assist you with this as well.

I try to look at it as if the cup is half full, the missing part is full of possibilities!

Are There Disparities in Stem Cell Transplant Outcomes?

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Are There Disparities in Stem Cell Transplant Outcomes? from Patient Empowerment Network on Vimeo.

What do myeloproliferative neoplasm (MPN) patients need to know about disparities in stem cell transplant outcomes? Expert Dr. Idoroenyi Amanam from City of Hope explains key factors that impact the outcomes of stem cell transplants and the importance of finding fully matched donors.

Descargar Guía|Download Guide 

See More From [ACT]IVATED MPN

Related Resources:

Are There Any MPN Disparities in Subtypes and Genetics

Are There Any MPN Disparities in Subtypes and Genetics?

 Understanding MPN Treatment Goals and Shared Decision-Making

Understanding MPN Treatment Goals and Shared Decision-Making

 Emerging MPN Therapies in the Research Pipeline

Emerging MPN Therapies in the Research Pipeline

Transcript:

Lisa Hatfield:

Dr. Amanam, does race or ethnicity play a role in outcomes of stem cell transplantation?

Dr. Indoroenyi Amanam:

Yes. There have been some really great studies looking at this. And I think in general, we know that health disparities are a major issue for racial, ethnic, and socioeconomic disadvantaged groups. Stem cell transplant is a curative therapy for blood disorders. And we’ve looked at a variety of different, there have been multiple approaches to assess like where these disparities come from or if there are disparities from specific groups. And I think the Affordable Care Act was great in allowing expansion and insurance coverage to multiple groups and increased access to care. But that hasn’t solved the problem.

And so, one of the issues we’ve seen is that providers themselves do not refer patients proportionately. So from proportion if you’re African American, Hispanic, if you are coming from a ZIP code that your meaning income is lower, that there are some instances where referrals for transplant don’t occur in equal rates.

And we’ve also seen that even if you’re insured and you’re African American or Hispanic, referral rates are still lower. And so that’s something that, it’s something that we have to work to improve. And you know, one big thing for transplant is that you have to have donors. You have to have donors who are matches for these patients who have these disorders who need a transplant. And we do know that African Americans, Hispanics, and Asians have lower chances of finding a fully matched donor compared to white Americans. And so, why that’s really important is that when you look at rates of complications after transplant, we do know that the level of match of the donor does play a part in that. Namely the chances of the patient relapsing after the bone marrow transplant and the rates of graft-versus-host disease are significantly higher.

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Are There Any MPN Disparities in Subtypes and Genetics?

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Are There Any MPN Disparities in Subtypes and Genetics? from Patient Empowerment Network on Vimeo.

Are there any myeloproliferative neoplasm (MPN) disparities seen in subtypes and genetics? Expert Dr. Idoroenyi Amanam from City of Hope explains what studies have shown, the role of access to care, genetics of African Americans, and questions to ask your doctor. 

[ACT]IVATION TIP:

“…if you have a myeloproliferative neoplasm and you have some specific complications, and there are treatment options offered to you, I would ask your provider if there are any differences in outcomes related to if you are a Hispanic woman or if you’re a Black male, or if you’re a Caucasian female, I think it’s important to understand if there are potentially differences in the outcomes related to the treatments, and then you can maybe tailor your treatment specific to your ethnicity and sex.”

Descargar Guía|Download Guide 

See More From [ACT]IVATED MPN

Related Resources:

Myeloproliferative Neoplasm Basics for Newly Diagnosed Patients

Myeloproliferative Neoplasm Basics for Newly Diagnosed Patients

 MPN-Related Complications | Are BIPOC Patients at Higher Risk

MPN-Related Complications | Are BIPOC Patients at Higher Risk?

 Bone Marrow Registries | What Myeloproliferative Neoplasm Patients Should Know

Bone Marrow Registries | What Myeloproliferative Neoplasm Patients Should Know

Transcript:

Lisa Hatfield:

Dr. Amanam, can you speak to the disparities seen in MPNs and other subtypes and the role of genetics?

Dr. Indoroenyi Amanam:

Yeah, I think this is a great question, especially in the context of when we think about socioeconomic and racial disparities. I think that it is very important to continue to address those issues. I think the Affordable Care Act assisted in giving wider access to some patients who would not have the opportunity to receive care. But we have to go beyond the idea that race is a social construct. I think there are biologic differences. There are genetic hereditary differences between different groups. 

When you look at African Americans and you look at their genes and the median amount of genes of African descent. About half of African Americans have less than 80 percent of genes of African descent, which means that they’re biologically…there are biological differences that are related to their experience here in America and in the Western Hemisphere. And they have a more diverse gene pool, which may contribute or not contribute to cancers and other diseases. Other studies to really understand what are the scientific biologic hereditary differences and how we can improve those outcomes once we understand those. And so for MPNs, we don’t really have a good understanding of that, and I think that’s definitely a space for all of us within this disease for us to really improve upon.

My activation tip for this question would be, if you have a myeloproliferative neoplasm and you have some specific complications, and there are treatment options offered to you, I would ask your provider if there are any differences in outcomes related to if you are a Hispanic woman or if you’re a Black male, or if you’re a Caucasian female, I think it’s important to understand if there are potentially differences in the outcomes related to the treatments, and then you can maybe tailor your treatment specific to your ethnicity and sex.

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Understanding the Oncology Care Model

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Some of you may have received a letter from your oncologist notifying you that your oncologist is participating in a program called the Oncology Care Model. It was sent out to Medicare patients who are currently being treated by this provider. This letter informs you that you still have all the Medicare rights and protections including which health care provider you see. However, if you do not want to participate in this program, your opting out will require you to find a new provider. This can be very daunting for a patient that has been getting care and have a relationship established. Therefore, I want to give a brief overview of the Oncology Care Model, (OCM).

This program was developed by the Center for Medicare and Medicaid Innovation (Innovation Center) which was established by the Social Security Act and added to the Affordable Care Act. Its purpose was to test innovative payment and service delivery models to reduce program expenditures and improve quality for Medicare, Medicaid, and Children’s Insurance Program beneficiaries. The practices participating in this program have committed to providing enhanced services to Medicare beneficiaries, which includes care coordination and navigation, and to using national treatment guidelines for care.

Because cancer is such a devastating disease and because a significant proportion of those diagnosed with cancer are over 65 years of age and Medicare beneficiaries, this provided the OCM, CMS, in partnership with oncologists, other providers and commercial health insurance plans, the opportunity to support better quality care, better health, and lower cost for this patient population. It is intended to improve our nation’s health by providing clear measurable goals and a timeline to move Medicare and the US healthcare system toward paying providers on the quality of care rather than the quantity of care that they give their patients.

OCM focuses on Medicare Fee for Services beneficiaries receiving Chemotherapy treatment and includes the spectrum of care provided to a patient during a six-month episode that begins with chemotherapy.

The benefit to the patient would include enhanced services, including

  • The core functions of patient navigation to find other patient-focused resources.
  • A care plan that that meets your needs
  • Patient access 24 hours a day, 7 days a week to an appropriate clinician who has real-time access to the practice’s medical records: and
  • Treatment with therapies consistent with nationally recognized clinical guidelines.

There is no additional cost to patients to participate in this program. Medicare will pay for the full amount of the services. There is however a survey that patients would need to participate in to provide feedback to help improve care for all people with Medicare.

To get a good understanding of this program so that you can make the best decision regarding your care, don’t hesitate to share with your treatment team any questions or concerns you may have. Visit online at www.innovation.cms.gov/initiatives/oncology-care or call 1-800-MEDICARE (1-800-633-4227).