Infographics

A Migraine Patient’s Guide to Choosing a Health Plan: HMPF

A Migraine Patient’s Guide to Choosing a Health Plan: HMPF 1- Check for your health care providers Out-of-network appointments can be pricey. Review the network of approved providers before choosing your plan. 2- Review the formulary. Find out if your regular medications and devices are covered – and if they are “preferred” by the health plan. 3- Know your costs Monthly premiums matter. But so do annual deductibles and co-pays…

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Migraine Patient’s Guide to Dealing with Insurance Denials: HMPF

HMPF A Migraine Patient’s Guide to Dealing with Insurance Denials 1- Identify the “why?” Denials can stem from issues like: Clerical errors Services considered “not medically necessary” Medications that need prior authorization 2- Ask for direction Your insurer can answer questions about the denial. Your doctor’s office may offer advice about appealing. 3- Document & record Keep notes on phone calls and important dates. Maintain copies of the appeal letter…

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Taking Action on Insurance Denials: HMPF

Taking Action on Insurance Denials: HMPF Myth: My insurance denied coverage for my migraine treatment. I have no choice but to accept their decision. Truth: Insurance denials are not final. You can appeal using your insurance company. Action: Do not give up. Appeal the denial with your insurance company. Provide supporting documentation from your doctor. If unsuccessful, file a consumer complaint. Request an external review through your state’s insurance commissioner…

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Know Your Coverage – HMPF

Know Your Coverage - HMPF Health plans maintain lists of covered medications and devices. THESE ARE KNOWN AS FORMULARIES. Formularies are often updated at the end of the calendar year. BUT COVERAGE CAN ALSO CHANGE DURING THE YEAR due to: New medications becoming available New approved uses for existing medication Changes to medical guidelines TO RECEIVE OPTIMAL AND TIMELY CARE, patients should be aware of their health plan’s coverage throughout…

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How Inadequate Treatment Leads to Chronic Migraine- HMPF

How Inadequate Treatment Leads to Chronic Migraine- HMPF How Inadequate Treatment Leads to Chronic Migraine- Headache and Migraine Policy Forum   SOME PEOPLE START WITH EPISODIC MIGRAINE, having 14 attacks or fewer each month. THEY SEEK HELP BUT: Can’t get in to see a headache specialist Struggle to find the right treatment, including opioid use Are misdiagnosed with anxiety, sinus infections or other common conditions May frequent the ER for…

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Health Plan Coverage & Migraine Disease: HMPF

HMPF-Migraine-Perception-Reality-March2021 Headache and Migraine Policy Forum HEALTH PLAN COVERAGE & MIGRAINE DISEASE Perception vs Reality Perception: Migraine patients who have insurance can access the treatment they need. Reality: Even covered patients often face barriers. HR professionals report barriers such as: 34% Prior authorization 34% Step therapy 49% Quantity limits Meanwhile, 64% of HR professionals say employees with migraine disease work during attacks.   Perception: HR benefit managers simply administer health…

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