CMS has announced a Special COVID-19 Open Enrollment Period for people having difficulty finding health insurance, spanning February 15-May 15, 2021. For details see https://www.cms.gov/newsroom/fact-sheets/2021-special-enrollment-period-response-covid-19-emergency. Rules and procedures can be very complicated. Your dialysis facility Social Worker may be able to provide help or direct you to other assistance. You can also connect to free detailed, unbiased advice on navigating the health insurance labyrinth, tailored to your specific situation, from a trained expert in health insurance options, rules, and procedures, at https://www.shiptacenter.org/.
Rules and procedures also vary by state; a quick overview for the six states in ESRD Networks 16 and 18 follows:
Alaska: For details see https://www.healthinsurance.org/alaska-state-health-insurance-exchange/. No apparent Special COVID-19 Open Enrollment Period, but a “qualifying event” (https://www.healthinsurance.org/obamacare/qualifying-events-that-can-get-you-coverage/) may create one for you.
California: For details see https://www.healthinsurance.org/california-state-health-insurance-exchange/. State-specific Special COVID-19 Open Enrollment Period February 1-May 15, 2021.
Idaho: For general details, see https://www.healthinsurance.org/idaho-state-health-insurance-exchange/. No Special COVID-19 Open Enrollment Period, but some insurance plans are open all year (https://www.healthinsurance.org/idaho-short-term-health-insurance/#renew), and if you have a “qualifying event” (https://www.healthinsurance.org/obamacare/qualifying-events-that-can-get-you-coverage/), you can enroll anytime.
Montana: For details see https://www.healthinsurance.org/montana-state-health-insurance-exchange/. No apparent Special COVID-19 Open Enrollment Period, but a “qualifying event” (https://www.healthinsurance.org/obamacare/qualifying-events-that-can-get-you-coverage/) will create one just for you.
Oregon: For details see https://www.healthinsurance.org/oregon-state-health-insurance-exchange/. No apparent Special COVID-19 Open Enrollment Period, but a “qualifying event” (https://www.healthinsurance.org/obamacare/qualifying-events-that-can-get-you-coverage/), including loss of employer-sponsored health insurance, can create one just for you.
Washington: For details see https://www.healthinsurance.org/washington-state-health-insurance-exchange/. Special COVID-19 Open Enrollment Period February 15-May 15, 2021.
The Renal Support Network KidneyTalk program presents a recorded podcast on Paying for Dialysis or Transplant. Founder Lori Hartwell asks Beth Witten, LCSW, for an overview of her wealth of knowledge about the complexities of health insurance coverage of kidney disease. Find this podcast at https://www.rsnhope.org/kidneytalk/paying-for-dialysis-or-transplant/, and a catalog of past KidneyTalk recordings at https://www.rsnhope.org/kidneytalk-podcast-show-kidney-disease/.
The Renal Support Network has published an excellent blog post titled Original Medicare vs. Medicare Advantage Plans: How Do I Decide? The post compares “plain vanilla” Medicare to Medicare Advantage (“MA” or sometimes, informally, “Medicare Part C”). Ongoing kidney patients will be eligible for MA plans in 2021 for the first time, and Medicare beneficiaries can switch plans until December 7, 2020. There are pros and cons to both, and each MA plan is unique, so kidney patients should huddle with their insurance advisors and their social worker to make sure that they enroll in the plan which best suits their individual situation. While MA plans can provide additional benefits, they are tied to specific provider groups (or “networks” – not to be confused with the ESRD Networks), and since they may provide very different advantages and disadvantages in different places, they must be evaluated individually.
The RSN blog post provides an excellent overview of the pros and cons of each type of plan, but can’t consider each plan in each location. That evaluation must be tailored to each specific patient and each specific place. The RSN post includes a series of questions that each patient should be asking themselves and their advisors. Find the post at https://www.rsnhope.org/health-library/original-medicare-vs-medicare-advantage-plans-how-do-i-decide/.
CMS has prepared a press release summarizing the steps that Medicare has taken in Oregon to help make health care available to wildfire victims, including opening special enrollment periods to allow out-of-season initiations or changes to Medicare coverage, various kinds of assistance to healthcare facilities, and help to displaced dialysis patients. Find the press release at https://www.cms.gov/newsroom/press-releases/cms-offers-comprehensive-support-oregon-due-wildfires.
Dialysis Patient Citizens will present a September 24, 2020 Spanish-language webinar on Manejando Mi Glucosa En Sangre Cuando Tengo Enfermedad Renal (Managing My Blood Glucose When I Have Kidney Disease), covering carbohydrates and their effect on blood glucose, how much carbs to eat, and how to avoid high and low blood glucose extremes. Find more information below, and register for this and future DPC webinars at https://www.dpcedcenter.org/news-events/education-webinars/.
Upcoming DPC webinars include:
- Things to Know About Medicare Advantage’s First Open Enrollment for Dialysis Patients – October 22, 2020,
- Looking Out for the Caregiver: Understanding the People Who Care for Dialysis Patients – November 19, 2020,
- Coping with the Holidays – December 17, 2020.
Home Dialysis Central has published a new blog post called Getting the Most out of Telehealth for Home Dialysis Patients, describing what’s covered and what isn’t by COVID-19-related and other laws and waivers, what current facility policies are likely to be, features to be taken advantage of, and tips for success. Find the post at https://homedialysis.org/news-and-research/blog/363-getting-the-most-out-of-telehealth-for-home-dialysis-patient.
We’ve published our Patient Newsletters for Winter 2020. They feature articles on treatment options, flu shots, grievances, access to care, how to stay informed by the Network, and how to help the Network improve patient care. Find them at:
We’ve updated the list of dialysis facilities and transplant centers in Alaska, Idaho, Montana, Oregon, and Washington. Find the new lists at https://nwrn.org/patients-a-family/dfc.html.
The Medical Education Institute has written a blog post on Social Security Policies Related to Medicare: A Primer. It’s really complicated, so it may be more appropriate for a Social Worker than a patient, but if the Primer is this complex, the Reality must be especially daunting – which makes a Primer all the more valuable. Find the Primer at https://homedialysis.org/news-and-research/blog/307-social-security-policies-related-to-medicare-a-primer.