November, 2014 Advocacy Survey

Dear HFM Family,

The HFM Advocacy Team is constantly working on your behalf. We want to remind everyone that open season for the insurance exchanges began today. This is the time of year that you should take inventory of your health insurance plan and be sure that you are adequately covered for all your healthcare needs. Be sure to read the fine print of your policies to avoid any unexpected pitfalls due to changes or revisions to your policies.

While working to be in a better position to advocate for the community, the chapter is taking a survey to collect data on issues and concerns relating to health insurance that may exist in the community. If you are experiencing any difficulty with your current coverage, or if you have been notified of future coverage concerns, we need to hear from you. Please take a moment to complete the survey. The data collected will enable us to best represent you with our constituents to advocate on your behalf. There is strength in numbers, so please help us help you!

Be Well,

Carletha Gates
Chair, Advocacy Committee
Hemophilia Foundation of Maryland

Emma Miller
Executive Director
Hemophilia Foundation of Maryland

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* 1. Are you a Maryland resident?

Yes

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* 2. What is your diagnosis:

Hemophilia

von Willebrand Disease

Other (please specify)

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* 3. Are you satisfied with your current insurance provider?

Yes

If no, please explain

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* 4. Are you satisfied with your current home care/specialty pharmacy company?

Yes

If no, please explain

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* 5. Have you been notified by your insurance provider that your co-pay and/or deductible will increase in 2015?

Yes

If Yes, please explain the increase

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* 6. Have you been notified by your insurance provider that you must use a specific home care/specialty pharmacy other than the one you currently use for your bleeding disorder needs?

Yes

If so, please explain which provider were you told to use and why?

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* 7. If you answered YES to question 6 above, would you be willing to provide a copy of the correspondence to HFM? We need evidence of any existing issues. You may redact your personal information.

Yes

Not applicable

You may email this information to Miller8043@comcast.net, fax it to HFM at 410.661.2308 or mail it to HFM, 13 Class Court, Parkville, MD 21234

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* 8. Does your homecare/specialty pharmacy company have a co-pay assistance program?

Yes

If yes, please explain

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* 9. If you answered YES to question 8 above, have you utilized the co-pay program?

Yes

Not applicable

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* 10. Are you familiar with your factor manufacturer co-pay assistance program?

Yes

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* 11. If you answered YES to question 10 above, have you utilized the co-pay program?

Yes

Not applicable

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* 12. Please list any other concerns you have with your insurance provider.

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* 13. Who is your current insurance provider? (optional, but very helpful)

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* 14. Do you wish to be contacted by the chapter to further discuss your concerns?

Yes

November, 2014 Advocacy Survey

Question Title

* 1. Are you a Maryland resident?

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* 2. What is your diagnosis:

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* 3. Are you satisfied with your current insurance provider?

Question Title

* 4. Are you satisfied with your current home care/specialty pharmacy company?

Question Title

* 5. Have you been notified by your insurance provider that your co-pay and/or deductible will increase in 2015?

Question Title

* 6. Have you been notified by your insurance provider that you must use a specific home care/specialty pharmacy other than the one you currently use for your bleeding disorder needs?

Question Title

* 7. If you answered YES to question 6 above, would you be willing to provide a copy of the correspondence to HFM? We need evidence of any existing issues. You may redact your personal information.

Question Title

* 8. Does your homecare/specialty pharmacy company have a co-pay assistance program?

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* 9. If you answered YES to question 8 above, have you utilized the co-pay program?

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* 10. Are you familiar with your factor manufacturer co-pay assistance program?

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* 11. If you answered YES to question 10 above, have you utilized the co-pay program?

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* 12. Please list any other concerns you have with your insurance provider.

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* 13. Who is your current insurance provider? (optional, but very helpful)

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* 14. Do you wish to be contacted by the chapter to further discuss your concerns?

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* 15. If you answered YES to question 14, please provide your contact information. Name/Telephone Number and email address (optional).

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* 16. What is your name (optional)