HIV Supplemental Health Policy

Living with HIV has become much easier as technology and medicine combine to develop viable solutions. Treatments are more effective and the majority of people living with HIV are living longer, healthier lives. However, this advancement comes at a price, and the costs of the care and medications you need may exceed the limits of your healthcare coverage.

HIV/AIDS Facts

• Over 1 million people in the United States are living with HIV
• 1 in 5 people are unaware they have HIV
• Over 619,000 individuals have died because of AIDS
• Gay and bisexual men are most severely affected by the disease
• African Americans make up 46% of those who are infected

Where Do I Get Supplemental HIV Health Insurance?

If you’ve been diagnosed with HIV, you will need health insurance to help pay for treatments and prescriptions. While you may have a basic healthcare plan in place, it may not be adequate to help you manage the costs of your medications, doctor’s visits and other healthcare needs.

On average, HIV treatments can cost anywhere from $14,000 to $20,000 per year, and even with health coverage, co-pays and prescription costs can really add up. To help keep your finances in order, here are some healthcare and supplemental options that may be available to you:

• Group insurance: This is one of the best ways to get health insurance from a cost standpoint, but it’s usually only available through an employer. With group coverage, comprehensive health care is much more affordable because your employer pays the majority of your premium and your “risk” is spread out over a large group. Many employer programs offer supplemental health insurance if you would like to augment your standard plan. The best aspect of group coverage is that pre-existing conditions such as HIV, are not considered when you apply for coverage.
• Medicare: Medicare coverage is typically available to those 65 and over. However, your health condition may make you eligible at a younger age. If you qualify, due to illness or disability, Medicare may be an excellent way to get supplemental HIV or AIDS health insurance. This is a federally funded healthcare program that can provide comprehensive care but you must qualify first. With each federal healthcare program, purchasing a form of supplemental insurance may help cut costs dramatically but Medicare and Medicaid help form a solid base of health insurance.
• Medigap: Medigap is a Medicare supplemental policy designed to help you cover your excess healthcare costs that are not covered by Medicare. If you have Medicare Part A and Medicare Part B, you can buy a Medigap policy from an agent who is licensed to offer this supplemental coverage in your state. An independent agent in your area who specializes in health insurance can help you review this coverage and decide whether it is appropriate for you.
• Medicaid: You may qualify for assistance from this federally funded healthcare program if your income is below a specific range. Developed to help support low income families’ healthcare needs, Medicaid is run by individual states and can provide comprehensive coverage if you’re eligible. Check with your local state department to apply.
• AIDS Drug Assistance Program (ADAP): This program, offered through the federal government, provides medications for those who are HIV positive. As with other government-run programs, you must apply and qualify for ADAP. However, the income restrictions may not be as stringent as those for Medicaid.
• Ryan White HIV/AIDS Program: The Ryan White Program is administered by the Department of Health and Human Services, but is run by individual agencies in cities across the country. It is not a form of HIV insurance; it primarily provides outpatient care and is a great option if you can’t find coverage.

Finding the best way to supplement your health coverage can be difficult. A local independent agent in the Trusted Choice network can be an excellent resource, helping you review several different options. Independent insurance agents have access to a broad range of insurance companies, and can research various plans for you.

Considerations When Shopping for Supplemental HIV Insurance

With the variety of insurance plans available, it’s important to know how policy restrictions and limitations can affect you. Some insurance plans, such as HMOs may require that you always see a primary doctor for a referral while others, such as PPOs, allow you to work within a network of providers at will. Living with HIV/AIDS may require you to visit multiple specialists, which can be costly depending on your insurance plan.

Ask about deductibles and coverage limits. A high deductible will leave you with cheaper premiums, but you have to cover your medical expenses until the deductible is met. Insurers can no longer impose lifetime limits on insurance policies, but they may impose a condition-specific coverage limit. Prescription coverage is essential. A Trusted Choice member agent can research supplemental HIV positive health insurance plans and will help you get answers to your supplemental insurance questions.

The Affordable Care Act, Insurance and HIV

Luckily, more affordable health insurance may be coming in 2014 for those diagnosed with HIV/AIDS. In 2010, the law forbade insurance companies from denying coverage to children with HIV or AIDS, and they aren’t allowed to cancel coverage because of application mistakes. Lifetime limits are now illegal and as of 2014, it will likely be illegal for insurance companies to deny coverage or charge exorbitant premiums to people living with pre-existing conditions. This is important news for everyone affected by HIV/AIDS.