Friday, November 21, 2014
By Jessica W. Hart, State Advocacy Manager
Are your prescription medications covered by Medicare? If they are, you should check your plan because Medicare Part D plans are changing and there might be a better option. Use this guide to compare plans and find one that is best for you.
If you or a family member receives Social Security Disability Income (SSDI), prescriptions are probably covered by a Medicare D plan. Medicare Part D open enrollment is the time of year when you can look at prescription drug plans in Medicare and keep your current plan or sign-up for another one. In 2015 all Part D plans are changing so now is the time to look. Plans are making changes to benefits and costs, and there are new plans in many areas of the country.
So, how could your Medicare Part D plan change?
Your current plan could change:
- The monthly premium
- The annual deductible
- Your share of the costs (co-payment or coinsurance)
- The list of the drugs it covers (formulary)
- Additional coverage, if any, it offers beyond the discounts in the coverage gap
- Use of policies that may restrict access to certain drugs, such as:
- Requiring your doctor to justify why you need a certain drug before the plan will pay for it (prior authorization)
- Requiring your doctor to prescribe a different drug in the same class of drugs first (step therapy)
- Only letting you buy a certain amount of a drug at a time (quantity limits)
Use Medicare's plan finder to check to see what your plan is and if it still meets your needs. Enrollment for Medicare prescription drug coverage is open until Dec. 7, 2014.
The 2015 Medicare Prescription Drug Annual Open Enrollment guide is an easy read to help you explore the options. The guide is produced by Medicare Access for Patients Rx (MAPRx). NAMI is a member of MAPRx, which brings together organizations serving beneficiaries, family caregivers and health professionals to improve access to prescription medications and safeguard the well-being of Medicare Prescription Drug Coverage (Part D) beneficiaries.
Read more about the changes to Medicare Part D.
Friday, November 14, 2014
It’s time to look at your health care needs and options.
If you don’t have health insurance or are looking for more affordable health insurance and haven't looked at the Health Insurance Marketplace―open enrollment is the time to look. During “open enrollment” you can buy private health insurance through the marketplace in each state. Depending on your income you can get financial help to pay for health insurance. If you have affordable employer-provided health insurance or are already covered by Medicaid or Medicare you cannot receive financial help paying for private health insurance coverage.
Do You Already Have Health Insurance through the Marketplace?If you do, you must re-enroll every year or you will be automatically re-enrolled. It is also important to report any changes to your income to the marketplace.
- This is a good time to check your health insurance coverage and see if it still meets your health and mental health care needs.
- Anyone can change health care plans during open enrollment, but most people will be re-enrolled automatically if they take no action.
- Carefully read all health insurance notices and updates.
Check Your Coverage
- Even if you like your health plan, new plans may be available and premiums or cost sharing may have changed since last year.
- Even if your income has not changed, you could be eligible for more financial assistance.
If You Live with a Mental Illness, Pay Attention to Possible Changes
- Are a broad range of health and mental health care providers included in the health plan’s network of providers?
- Are there enough medical specialists in the network to meet your needs?
- Are needed medications included in the plan’s list of covered prescription drugs?
- Is there adequate access to non-clinical, mental health-specific services and supports?
- Does the plan have service limits, such as caps on the number of office visits for therapy services?
- Are mental health and substance use services covered to the same extent as other “physical” health benefits are covered?
Where You Can Get Help
Health insurance can be complicated. If you or your family member needs help understanding your options, Healthcare.gov can help. It breaks down health insurance terminology and will tell you where you can get help in your local community. Each state has health insurance “navigators” to assist individuals with enrollment in health insurance. You can also call the 24-hour Healthcare.gov phone line for help at 1-800-318-2596.
The Kaiser Family Foundation also put together some great resources including a video explaining health insurance and a calculator you can use to figure out about how much health insurance will cost for you if you buy it through the Health Insurance Marketplace.
Important Dates to RememberNov. 15, 2014
Open enrollment begins
Dec. 15, 2014
Enroll before this date to have coverage Jan. 1, 2015
Feb. 15, 2015
Open enrollment ends
More information on specific topics for each state can be found at the National Disability Navigator Resource Collaborative.
Monday, November 10, 2014
Thursday, November 6, 2014
|Asten Jones, peer support specialist at The Center for Health Care |
Services in San Antonio Texas.
- A jail diversion program. The Bexar County Jail (in Texas) was once immensely overcrowded but now has a continuous surplus of roughly 1,000 empty beds.
- A $50 million reduction in jail and inappropriate emergency room costs since 2008.
- Training of more than 2,500 law enforcement officers to work successfully with people living with serious mental illness.
- A safe sleeping area for more than 700 individuals in its Prospects Courtyard, a safe place for homeless individuals to seek medical and psychiatric treatment as well as fulfill their basic living needs.
Tuesday, October 28, 2014
By Darcy Gruttadaro, Director, NAMI Child and Adolescent Action Center
For those experiencing psychosis, early identification and intervention matter—a lot. It lessens the long-term severity and often prevents psychosis from worsening. An effective early identification and intervention program should include the following coordinated array of services and supports:
- Supported education and employment.
- Cognitive behavioral therapy.
- Peer support.
- Family support and education.
- Case management.
- Community outreach.
- Low dose antipsychotic medication.
These services work so well because they are offered together to provide the skills and support that youth and young adults need to get better. They also take into account the context of a young person’s life and the key role that peers and families play in recovery.
FEP programs reduce costly hospitalizations and put youth and young adults with psychosis on an early path to recovery.
When you fund upstream interventions, you can prevent the tragedies associated with untreated mental illness: school failure, unemployment, hospitalizations, homelessness, jail and suicide. Investing in effective programs that intervene early produces far better outcomes for individuals, families and communities.
There are effective strategies available, so why aren’t more young people getting help? One of the main reasons is that these services and supports are simply not available in communities. However, there has been progress made recently that to help ensure the availability of these resources in more towns and cities across the U.S.
One significant event is that Congress has now required states to use 5 percent of their Mental Health Block Grant for First Episode Psychosis (FEP) programs. This means that states are obligated to set aside a certain amount of their federal funding to address the importance of early intervention.
How Is NAMI Helping
We recognize the urgency in expanding these programs. Our advocacy work and involvement in these programs is happening at all levels of the organization.
NAMI NYC Metro is partnering with OnTrackNY, an FEP program, in providing support groups and peer support for youth and young adults experiencing early psychosis. NAMI Connecticut is offering peer-run young adult support groups located close to FEP programs to make it easy for young adults to join. NAMI Minnesota has partnered with an FEP program and is creating education and support programs for youth experiencing early psychosis and their families.
Oregon was an early adopter of these services and supports, having witnessed the success of these programs in Australia. Tamara Sale, the director of the Early Assessment and Support Alliance (EASA) in Oregon and a former long-time NAMI Oregon board member, shared how their program works successfully with youth and young adults experiencing early psychosis.
The EASA program recognizes that it can be difficult to engage youth and young adults experiencing early psychosis, so it uses strategic community approaches that meet young people where they are with messages of hope and relevance to their lives. They are flexible and persistent, even with youth and young adults that seem entirely uninterested in mental health care.
What You Can Do
FEP programs exist in a handful of communities and more must be done to spread these programs across the country. Here is how you can make sure that happens.
- Learn more about FEP programs. Understand why these programs are pivotal in creating better outcomes.
- Email or Tweet your Congressional members to thank them and to ask for their continued support of FEP programs.
- Connect with your NAMI Affiliate in advocating at the state and federal levels for FEP programs so that youth and young adults experiencing early psychosis can access effective services and supports.
We can and must change the trajectory of people’s lives by intervening early with recovery-oriented and effective services. We simply cannot afford to wait.
Monday, October 27, 2014
By Bob Carolla, NAMI Director of Media Relations
|Flickr / Hanna Horwarth|
Halloween is big business. According to the National Retail Federation, Americans will spend $7 billion this year on festive celebrations, including pumpkins—new sets of pumpkin carving tools—and Katniss Everdeen, Ninja Turtle, Batman and Elsa and Anna costumes.
Seventy-five percent of people will give out candy. About 40 percent will wear costumes—the average cost of which is $27. Thirty percent will visit haunted house attractions.
Unfortunately, there are too many cases where haunted houses are set up as “haunted asylums” with depictions of people with mental illness as violent monsters. Costumes also are sold of “mental patients” in straitjackets.
Stigma is No Treat
Even worse are cases where a person will hang a figure in a noose from a tree in their yard—not knowing or recalling that someone who drives by every day had a son or daughter who died by suicide. Let alone the symbolism of racial and ethnic lynching that nooses represent.
These kinds of costumes and attraction perpetuate the stigma that traditionally surrounds mental illness. They are offensive stereotypes. The U.S. Surgeon General warned 15 years ago that stigma is a major barrier to people reaching out for mental health care when they need it. People living with mental illness also internalize stigma, which jeopardizes recovery.
NAMI loves Halloween as much as anyone. But would anyone sponsor a haunted attraction based on a cancer ward? How about a veteran’s hospital with ghosts who died from suicide while being treated for posttraumatic stress disorder (PTSD)?
What Should You Really Be Concerned About?
Last year, NAMI received many comments about protests over Halloween stigma. Most individuals and families affected by mental illness agree with them.
“Portraying any individuals in a group as scary, wicked or dangerous because of an illness is insensitive, callous and mean,” said one advocate.
Please be kind while enjoying this wonderful holiday, let’s not hurt anyone buy being insensitive to their problems. There are hundreds of other choices for costumes.”
One person who lives with mental illness said that “haunts and bizarre things are just part of the holiday fun. Everyone is reinvented via costumes. I don't think we are singled out or stigmatized or made an object of, if people dress in a strait jacket.”
One dismissed concerns saying that the world has too much political correctness.” Another recommended that we “pick our battles” and that there are bigger concerns.
What do you think? Are some things okay while others are not? Here are some examples:
- Spirit Halloween’s mental patient costumes.
- Walmart’s Mental Patient Gown Costume.
- Party City’s “Asylum Party Ideas to Drive Them Mad” with decorations that include “an animated hanging asylum mental patient.”
- Pinterest bulletin board images for an Asylum Halloween.
- The Asylum Haunted House in Denver.
What You Can Do
Never underestimate the power of polite conversations by phone, email or social media to raise awareness.
- Let family, friends and local community groups know your concerns.
- Post comments on company or store Facebook pages.
- Send a message through website “contact” features—or after a little sleuthing, to the company’s CEOs or public relations executives. Their email addresses are sometimes listed under “corporate” or “investor” information.
- Contact the managers of local stores to ask that politely that costumes be removed from shelves and that they share your concern with regional managers to be communicated up the corporate chain.
For asylum attractions:
- Alert your local NAMI Affiliate, family and friends to phone or email the sponsor of an attraction. Post on the company Facebook or Twitter pages.
- Contact sponsors. Ask that offensive parts of an attraction or advertisements be removed. Changing a name and using “haunted castle” and generic “monster” themes may be all it takes.
- Ask for as group meeting. Be flexible and patient. In some cases a sponsor can’t make changes immediately but will agree to do so in the future. If so, ask for a public statement or letter. Use it also as an opportunity to find ways to work together looking forward for community education.
- Large commercial attractions may be difficult or slow to change because of the amount of financial investment.
- Local civic organizations, high school clubs or similar community groups have greater desire to resolve controversy--they often have no awareness of stigma issues and did not intend to offend.
A Teaching Moment
Contact local newspaper editors and television news directors. Educate them also about misconceptions about mental illness and your concerns.
If they have run promotional stories about a “Haunted Asylum”-type attraction, or related advertising ask them to also run a story about the “other side of the story.” Ask them to check out for themselves any offensive merchandise in a local store or bring a sample to a meeting.
Don’t be surprised if some people react by saying “It’s only Halloween” or are even nasty. Take the high road. Stay polite and respectful in the public dialogue. Even if it seems that too many people disagree with your position, you win simply by raising awareness.