Health Insurance Marketplace Reopening!
Many Virginians who are above the income limits for Medicaid/FAMIS, but who need health insurance, will soon have a new opportunity to obtain private coverage and the federal subsidies that make it affordable! President Biden has signed an Executive Order authorizing the federal Health Insurance Marketplace to reopen from February 15 – May 15, 2021.
Virginians can apply for health insurance through the Marketplace on their own at www.healthcare.gov. Those who need help understanding available coverage options, or applying for Marketplace coverage can obtain it by contacting a local Navigator or Certified Application Counselor. Visit coverva.org/findhelp to find the one closest to you. To learn more about this opportunity and for enrollment assistance, click here.
Don’t forget - Virginians can apply for Medicaid or FAMIS year-round.
COVID-19 Vaccine Resources for your Patients
The Virginia Department of Health has two new resources available to share with your patients as the vaccine rollout continues - an educational toolkit and an interactive survey tool to help patients determine their eligibility for the different phases of vaccine rollout. The toolkit includes materials to educate the public about the COVID-19 vaccine. There are several handouts that cover FAQs about the vaccine, including how it was developed, approved, and manufactured, differences between the two approved vaccines, what to expect when you get the vaccine, etc. Some of the handouts are available in multiple languages, and all are free to download and share with your patients. Visit the toolkit of resources on the VDH page here.
The survey tool can be accessed here. It features a list of questions about an individual’s risk profile and exposure and will identify the vaccine phase for which they are eligible. Share it with your patients, friends and family today!
Scholarship Opportunity Available - Informa Connect Hosts Virtual PAP Critical Update Conference
On March 8 – 10, the 2021 Patient Assistance and Access Programs Critical Update virtual conference will convene stakeholders in the healthcare community to discuss models for institutional PAPs, medication assistance, prescription access, drug affordability and copay support. Check out the agenda and learn more about this conference here. All non-profit free healthcare clinics, advocates and patient organizations interested in this event are encouraged to apply for a Summit Scholarship to be considered for a complimentary registration (valued at $599). Scholarship questions can be directed to Allie Spica at alexandra.spica@informa.com listed on the application. Deadline to apply for a scholarship is February 19, 2021. Be sure to save-the-date for Part 2 of the conference which is planned for August 17-19 in Baltimore, MD where additional scholarship opportunities may be available for reapplication.
Highlights of Important PAP Updates & Resources
Merck’s PAP is spinning off select products which include: Asmanex, Asmanex HFA, Crixivan, Dulera, Intron A, Maxalt, Maxalt MLT, Nasonex, Propecia, Singulair Oral Granules, Vytorin and Zetia in the first half of 2021 to Organon. It is not yet known if Organon will continue with a PAP. Many of these products are still available to currently enrolled patients through Merck’s PAP and refills can be obtained while inventory remains available. Contact Merck’s PAP regarding your specific patient(s) eligibility. A list of possible alternatives available on other PAPs will be distributed through email. Merck has plans to add new products to its program, but at this time those are unknown. Stay tuned for additional information as it becomes available.
Arbor’s Patient Assistance Program has a new fax number. Be sure to fax applications to 877-619-6574. The application is current in TPC, while the Arbor website is working to load the current application.
Mylan merged with Viatris in November. Patient assistance remains available for Mylan products, while application forms and phone/fax numbers have not yet changed, only the company name. Emails can be directed to mylanPAP@viatris.com.
New Eyes assists individuals who have no other resources to purchase a basic pair of single or lined bifocal eyeglasses. This program is available under the supply formulary section of the Medications screen in TPC. Applicant must have an eyeglasses prescription dated within the past 24 months. Advocates must order eyeglasses on behalf of patients through an online application process. In response to COVID-19, New Eyes is now able to accept applications from individuals who do not have a caseworker or advocate to apply on their behalf. Special considerations may be reviewed on a case-by-case basis.
Be sure to check out Program Changes in TPC for additional updates!
Commonshare Pharmacy Offers Free Prescriptions to VIRGINIA Residents
A new non-profit pharmacy, Commonshare, currently has over 190 free medications available on its formulary. Available medications are mostly generics, but some brandname medications are available. This includes insulin, which may be helpful to your patients that are not eligible for insulin via the PAPs. Patients must meet the FPL income threshold for the needed medication designated on the formulary in order to be eligible. Commonshare is only licensed to dispense in Virginia. It offers delivery within a 30-mile radius or will ship medication to other parts of Virginia at no charge. Download the eligibility form for free products here.
Changes Coming Soon to Virginia’s Medicaid/FAMIS Programs!
“40-Quarter Rule” to be Eliminated in April
Virginia’s Medicaid/FAMIS programs will see several exciting improvements in 2021, thanks to changes put in place by the Virginia General Assembly and Governor Northam.
Beginning in April 2021, adults who are Lawful Permanent Residents (LPRs, or “green-card-holders”) will no longer be required to have 40 qualifying quarters of work in order to be eligible for Medicaid! For many years, Virginia’s “40-Quarter Rule” has prevented many otherwise-eligible green-card-holder adults from being able to enroll in Medicaid, even if they meet all other eligibility requirements (including having been lawfully present in the U.S. for 5 years or longer).
Individuals who may become eligible in April 2021 due to this change should be encouraged to apply or re-apply at that time, so that their eligibility can be re-determined. Keep in mind that some LPR Virginians who were ineligible for Medicaid because of the “40-Quarter Rule” may be enrolled in health insurance through the Health Insurance Marketplace, with financial help. Once these individuals become enrolled in Medicaid, it will be important for them to end their Marketplace plan, so they can avoid being billed for coverage they no longer need.
Click here to read more about other exciting changes to Medicaid/FAMIS happening later in 2021.
Want to learn more about Medicaid/FAMIS? Check out the SignUpNow Workshops Available LIVE and On-Demand
SignUpNow teaches the “ins and outs” of the eligibility requirements, application procedures, and post-enrollment information for Virginia’s Medicaid/FAMIS programs:
- New Adult Coverage
- Programs for children and pregnant women
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Plan First (family planning)
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Low Income Families and Children (LIFC) program
- Medicaid for Former Foster Care Youth
On-demand workshops can be completed when it’s convenient for you, wherever you are – one module at a time. The on-demand workshops consist of the same content as the live trainings, broken down into 20-30-minute modules. If you prefer to register for a live, virtual workshop, go to vhcf.org/workshops.
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Mark Your Calendars for Upcoming
TPC Virtual Trainings & Meetings
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Sign up for an online TPC training session if you are new to your organization and need to learn the basics. If you currently use TPC and are looking to refresh your skills or want to learn about additional advanced features, sign up for Advanced Training. To continue our support, we also host monthly calls where we provide updates and give users the opportunity for a Q & A session. It’s also a great opportunity to brainstorm and learn from other TPC users. Registration is not required to participate in the monthly calls. Zoom details are emailed out the week before and the week of the calls to current users. All sessions are Eastern Standard Time.
TPC Beginner Training
TPC Advanced Training
Monthly Support Calls (10 – 11am)
February 10, 2021
March 17, 2021
Save the Date: Virtual Spring Medication Assistance Roundtables
All TPC related staff are encouraged to participate in one of the upcoming virtual sessions that will be held on April 20th, April 22nd and April 28th. These Roundtables are designed to bring users together to discuss the ways each utilizes The Pharmacy Connection, exchange ideas, and share accomplishments and challenges. Changes in healthcare and PAP updates are just a few of the topics that will be covered. You don’t want to miss one of these sessions! Stay tuned to your email for information about registration!
Please check back for additions to the schedule and register today!
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