Dear PH Community,

Here in Washington, D.C., autumn has arrived with some cooler weather and the first golden and orange leaves. Fall means that vacations are mostly over, and school is back in session. It also means that the complex process of open enrollment is almost upon us. The Pulmonary Hypertension Association (PHA) is prepared to help make this year’s open enrollment process easier to understand.

For those of you who are new to the process, open enrollment describes the time each year when health insurance plans allow enrollees to add or change coverage without a penalty. Individuals with employer-based insurance should receive information about their open enrollment period from their employer. Medicare Open Enrollment officially starts on Oct. 15, followed by open enrollment for Marketplace (state and federal health insurance exchange) plans and most Medicaid plans on Nov. 1.

No matter what kind of insurance you have, things can change from year to year. The price of premiums can go up or down. The types of coverage can expand or decrease. Medications get added or removed from formularies. Keeping up with the changes in your plan can potentially be a challenging task.

Open enrollment offers you an opportunity to take stock of your insurance coverage and evaluate whether it meets the needs of you and your family. Your health care needs could have changed since you last renewed your coverage.  So even if you are happy with your current coverage, it’s important to make sure it will continue to meet your needs in 2020.

Picking the right insurance that can meet your individual needs may seem like an overwhelming task, especially for those in the pulmonary hypertension (PH) community. There are so many questions to consider. How much of my prescription costs will I have to pay out of pocket? Are my doctors in-network? Will I get a higher level of coverage from a plan with a more expensive premium?

PHA understands these concerns, and we are here to help you navigate your way through open enrollment. Beginning in next week’s PHA News, PHA will feature a series of articles that includes enrollment tools, tips and resources to help you with the open enrollment process.

Topics will include:

  • Questions to ask when choosing coverage and where to find one-on-one support.
  • Words of caution about short-term coverage and plans with co-pay “accumulators.”
  • When to alert your health care team about insurance changes.
  • Planning now for financial assistance in the new year.

Be sure to check your email inbox each Thursday for an open enrollment update. You can also visit www.PHAssociation.org/Patients/Insurance or contact PHA’s Treatment Access Program at 301-565-3004 x749.

Best wishes for the fall season. Please let me know your thoughts and ideas at BradWongPHA@PHAssociation.org. I look forward to hearing from you.

Best wishes,

Brad A. Wong
PHA President & CEO