Affordable Care Act Series: Part 2: New Coverage for Clinical Trials

Penny_Laing_NY_2009_7952As part of our ongoing series on the Affordable Care Act (ACA) and the changes that affect  transplant patients and recipients, we look at coverage changes related to clinical trials.

Have you ever considered participating in a clinical trial—but didn’t after learning your insurance wouldn’t cover the costs?  Recent changes from the Affordable Care Act (ACA), may allow you to reconsider.

Before the ACA, many clinical trials were not covered by insurers. This often meant that patients were unable to participate in them. Now, for approved clinical trials*, the ACA requires insurers to pay for items and services they would have paid for if the patient was not enrolled in the clinical trial. This change will allow more patients to participate to get the care they need.

This change of the ACA applies to all “non-grandfathered” health insurance plans. Non-grandfathered health insurance plans are plans that have made significant changes to their benefit structures and must comply with ACA requirements. While most plans will be non-grandfathered as of January 1, 2014, you should check with your insurance company if you have questions about the status of your health insurance plan.

There are many active BMT clinical trials studying disease treatments, graft-versus-host disease, post-transplant complications, and many other topics. To learn more about clinical trials, you can talk to your doctor or visit bethematch.org/patient. You can also visit clinicaltrials.gov.

We are here to help

Watch for more information about the ACA changes in upcoming editions of Living Now e-newsletter. If you have questions or need more information, please contact Be The Match at (888) 999-6743 or email patientinfo@nmdp.org.

*An approved clinical trial is one that is conducted for cancer or another life-threatening disease or condition and is federally funded. In order for a clinical trial to be considered federally funded it must be approved and funded by one the following organizations: National Institutes of Health (NIH), Centers for Disease Control and Prevention (CDC), Agency for Health Care Research and Quality (AHRQ), Food and Drug Administration (FDA), Centers for Medicare and Medicaid Services (CMS).

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