What’s New in Advances in Pulmonary Hypertension

Advances in Pulmonary Hypertension

Recent Issues Focus on Systemic Disease, Group 5 PAH

The August issue of Advances in Pulmonary Hypertension addresses pulmonary arterial hypertension (PAH) as a systemic disease. The previous issue examined Group 5 pulmonary hypertension (PH).

Advances in Pulmonary Hypertension is the Pulmonary Hypertension Association (PHA)’s quarterly peer-reviewed clinical journal. Advances is available for free online to the PH community. Volume 20, Issue 3, guest edited by Ioana R. Preston, M.D., includes articles on: ▶ Pulmonary Hypertension in Collagen Vascular Disorders. ▶ Hematologic Disorders and Pulmonary Hypertension. ▶ Obesity and Pulmonary Hypertension: A Discussion With Deborah Jo Levine and Anna Hemnes. ▶ Obesity and Pulmonary Hypertension. ▶ PH Roundtable: PH and COVID-19 as a Systemic Infection.

Volume 20, Issue 2 focuses on Group 5 PH. Group 5 is difficult to diagnose and challenging to manage because of the variability of underlying conditions and the ways PH presents, co-editor Anjali Vaidya, M.D., says.

“We hope that the readers will find this issue thought provoking, educational and practical,” co-editor Oksana Shlobin, M.D., says. “It is our hope that with the increased awareness of pulmonary hypertension in general, this often under-recognized and under-appreciated group will be on the forefront of research, as more guidance is needed to help clinicians caring for these complicated patients.” The Group 5 issue includes articles on: ▶ Metabolic Disorders of Pulmonary Hypertension. ▶ Myriad Presentations of Sickle Cell Disease-Related Pulmonary Hypertension. ▶ PH Roundtable: Sarcoidosis and Pulmonary Hypertension. ▶ PH Grand Rounds: An Interesting Case of Sarcoidosis▶ Associated Pulmonary Hypertension.

Visit meridian.allenpress.com/aph to read Volumes 2 and 3, or sign up to learn when the next issue is available.

It’s Not Too Early to Prepare for

Open Enrollment

No matter what kind of health insurance you have, it’s important to be aware of open enrollment season. Open enrollment is the period when anyone can add, drop or change coverage without specific qualifying events or financial penalties.

Here are a few things to consider during open enrollment:

f Double-check whether a plan will continue to cover essential medical tests and medications in the coming year. Many health insurance plans adjust their coverage from year to year.

f Alert your pulmonary hypertension (PH) specialist and specialty pharmacy when changing health insurance coverage for any reason. That can expedite pre-approval requirements and reduce your risk of temporarily losing coverage for your PH therapy.

f When choosing coverage, be cautious of copay accumulators, a cost-shifting practice by some health insurance plans. Those plans don’t apply manufacturer copay cards or other financial assistance to your deductible or out-of-pocket maximum. This model is most common in commercial plans but has been showing up in some Medicare Advantage plans.

Some states laws restrict copay accumulators. If you believe your health insurance plan includes a copay accumulator, PHA can provide information about the law in your state.

f Consider short-term, limited duration health insurance plans with caution. The inexpensive plans are designed to provide coverage during an emergency for people experiencing temporary gaps in health insurance coverage. Short-term plans don’t have to cover hospitalization, prescription drugs or preventative screening.

Get help if you need it. Contact PHA for more plan-selection resources at Insurance@ PHAssociation.org or 301-565-3004 x758.

CONSIDERATIONS WHEN CHOOSING COVERAGE

Your medical team and/or specialty pharmacy can be valuable in helping you understand and select coverage options. Here are items to consider as you compare health insurance products: in the coming year, such as routine tests or hospitalizations, and how much of those costs your plan will cover. f Whether prescription drug coverage is included or you must buy it separately.

f The premium, or monthly cost, to maintain your health insurance. Plans with more expensive premiums might cover more services or cover them at higher rates, making them better deals in the long run.

f Whether you must pay a deductible, or initial amount, before coverage begins.

f Medication you expect to take in the coming year, whether the health plan’s formulary covers them and your out-of-pocket responsibility for each.

f Whether the pharmacy network includes the specialty pharmacy that delivers your PH medications.

f Types of medical care you might need

DATES TO KNOW

MEDICAID, CHIP

In most states, Medicaid and CHIP enrollment are open year-round. Program names vary by state.

MEDICARE (www.Medicare.gov)

Oct. 15 to Dec. 7, 2021, with limited additional enrollment options Jan. 1 to March 31, 2022. f Switch between original Medicare and Medicare Advantage or between Medicare Advantage plans. f Add a Medicare Part D prescription drug plan, or switch between Part D plans. f Drop your Part D prescription drug coverage. f Coverage begins Jan. 1, 2022.

INSURANCE MARKETPLACE INDIVIDUAL COVERAGE (www.Healthcare.gov)

Nov. 1 to Dec. 15, 2021 f Enroll, disenroll or switch between plans. f Coverage begins Jan. 1, 2022.