The last week of National Kidney Month also marks the final week to buy health insurance in the Health Insurance Marketplace. This is the first step towards gaining access to the care you and your family need if you have kidney disease and no other health insurance. March 31st is the last day you can enroll in the Health Insurance Marketplace to get covered this year and receive financial assistance to help defray the costs, if you meet the income requirements.
If you have kidney disease or other health complications and don’t have insurance through your employer or Medicare, you can no longer be denied coverage if you have a pre-existing condition. So don’t let your health status stop you from checking out options in your state. This extends to transplant patients who are under age 65 and may lose their Medicare coverage three years after their transplant. The Health Insurance Marketplace can help transplant recipients whose Medicare coverage will expire continue to get the healthcare and medication coverage they need. Everyone can go to www.healthcare.gov to find the health insurance marketplace for their state. It doesn’t hurt to check out what options are available to you and what the costs will be.
If you have kidney disease or are at risk for kidney disease, make sure when shopping for coverage that you compare plans to ensure that the essential services you need are covered appropriately. Make sure the medications you need are covered and find out how much you will need to pay in co-payments or co-insurance to get them. This is particularly important if you have a kidney transplant because you will want to make sure your immunosuppressive drugs are covered and affordable. Check out the costs per visit for specialty care, such as nephrologist visits, and make sure the plan’s network includes these specialists and that their offices are in a convenient location for you. If you know you could need dialysis or a transplant during the year, compare policies to see how these treatments are covered, what the out-of-pocket expenses will be, and how far away from your home you will have to travel to find a dialysis clinic or transplant center. This may take a bit of research and work, but it will help you make sure that you are getting the benefits you need and expect. The good news is, there are navigators who can help you find out this information. You can access this assistance by visiting your state’s Marketplace website, which can be found through healthcare.gov.
In some states, Medicaid eligibility has expanded to everyone whose annual income is no more than 138% of the federal poverty level. Medicaid enrollment is ongoing, so beyond March 31, 2014, you can find out if you qualify for Medicaid through your state’s Marketplace year round.
Did you already find coverage in the Marketplace? Share your story with us!
Advocacy in Action 