Got HIV and Can’t Get Health Insurance? Here’s How Obamacare Works For You
If you’re HIV-positive or have AIDS and have tried purchasing private insurance like, ever, you probably know there are either one of two outcomes: 1) You’re offered policies with premiums and deductibles so high that you can’t afford it; or 2) You’re denied coverage outright because of your, ahem, pre-existing condition. And the alternatives and workarounds, while worth trying, simply don’t apply to tens of thousands of Americans. The health care bill that Democrats pushed through Congress and President Obama signed today, then is great news for you.
You just have to wait a few more months. The Patient Protection and Affordable Care Act (the full name of the new law) “allocates $5 billion for the establishment of ‘high risk pools’ within 90 days across the country,” relays Slate. “These group insurance plans will provide coverage only for people with pre-existing conditions who can’t find insurance through normal avenues. By law, they must take all eligible applicants and can’t charge more than the standard rates.”
Then, when the “guaranteed issue” clause of the Act kicks in on Jan. 1, 2014, insurers will be prohibited from denying coverage to anyone with a pre-existing condition. If you cannot afford insurance from a private carrier, you might be eligible for Medicaid or a statewide insurance exchange.
While some uninsured folks have found solutions for HIV and AIDS treatments through the Ryan White Care Act, it’s often a last resort. The new law will enable even healthy HIV-positive folks to secure HIV treatment coverage under standard insurance.
(NB: For whatever reason, we couldn’t find any information about how the health care overhaul impacts those with HIV on the website of Regent/Here Media’s HIV Plus magazine.
@Prissy – That’s pretty disgusting. And frankly, that’s why this needed to pass.
Preventing insurance from being denied because of pre-existing conditions, the removal of life time caps, and denying insurers the ability to drop patients that test positive “expensive” diseases like HIV/AIDS is a huge win. It’s pathetic that it has taken this long, but it’s a fantastic step in the right direction.
· Flag
It’s YEARS away from being acted on. Prissy- in most states you can get HIV meds for free if you are medically indigent through Ryan White money. (they just needed a straight white child’s name before congress would fund it).
Again, the issue of fair and equal treatment for gays comes up: If you can’t get married, and your employer doesn’t do D.P.’s, you can’t put your spouse on your health insurance.
· Flag
Hey I’m happy this passed. My stock in insurance companies have gone up because Obama has just given the insurance companies millions of new customers since Health Insurance is now required by law.
I think people should be denied for pre-existing conditions or charged higher premiums but not dropped if they get sick. I mean you can’t wreck a car and then go get car insurance can you and expect it to get fixed?
And according to Reuters, health insurance companies only make about 2% profit on average. What happened in California that Obama said were excessive profits was the sell of one of their business units which artificially inflated the balance sheet that year.
· Flag
I can’t believe it took America this long for a fair health system to take place. And to think nearly half the senate or whatever Americans call it voted against such a bill that would allow those without the financial aid they really need is just mind blowing. Gosh such people are such ignorant, selfish fools.
In Australia buying medication whether it’s for AIDS/HIV, cancer etc (with a script from the doctor) and if your earning less than 30-40K a year then your placed under concession which is $5.40 for ANY MEDICATION. So drugs which are $1000s are compensated by the government and its only yep $5.40. Call it ‘socialism’ but other developed countries like France and Great Britain which are democratic can hardly be called communist. And if you spend more than around $500 on medication per year, once you past that mark, any medication you buy after that is FREE (till the end of the year).
(Middle to High-income folks have to fork out maximum of $33.30 for expensive medication but nothing more)
All in all its glad to see Americans are taking a big step in the right direction. Best Wishes.
· Flag
@Tom: Humans are just like cars Tom. You can ride both.
In all seriousness though, I see we disagree on this. I don’t think I deserve to be called a douche bag. I can see your point of view seeing as you are HIV + and a recovering alcoholic and have probably had a hard time getting health insurance. I on the other hand am neither and have a good plan through my company. The main reason I tried to become employed through my current company is because I have had cancer and probably would be denied for pre-existing. I’m not mad at the insurance company. It’s a business and not a charity. They are in the business of creating a profit and impressing their shareholders. Is my job my dream job? No absolutely not. I wanted to follow my dream of being an artist but let’s face it. Being an Artist doesn’t carry great benefits.
I just find it ironic that no one seems to have a problem with the insurance companies denying or charging higher premiums to smokers and/or obese people.
· Flag
I am wondering how it will afect my ADAP program. The program picked up the (high) cost of my COBRA insurance many years ago, and still does since I am under the income limits. There is one more step after ADAP for those that get medicaid but can’t afford meds. I am so thankful for my ADAP program as it has kept me healthy and still does. The insurance premiums over the year are far cheaper dor the state of NY then paying my bills directly.
· Flag
@prissysissy: What’s crazy is that health care and medication are strangely divorced for many people with AIDS/HIV. There’s all kinds of programs to get medication (ADAP, Ryan White, drug companies’ compassionate use programs) but the programs for general medical care are overburdened and underfunded. It’s not uncommon for PWAs to be on HAART and seeing a specialist several times a year for monitoring/adjustments of drug therapy, but then have no coverage when they get the flu or have other non-HIV medical needs.
Hopefully this legislation will change that.
· Flag
@Matt: Smoking is an ongoing choice to damage your health each day. Getting many chronic diseases – such a multiple sclerosis, Crohn’s disease, ALS, etc. – for which people are denied coverage is not a choice.
To use your car analogy, one would expect that a chronic speeder pay higher insurance rates. One would not expect that you get charged astronomical rates because you bought one of those Toyotas that went kablooie through no fault of your own.
· Flag
Matt,
I do not like much about this new bill especially the public mandate but the one piece of the bill I do like is the pre-existing condition requirement. We probably need to quit talking about health care as insurance. Insurance implies that an event or situation requiring payout is very unlikley but our current health INSURANCE pays out every year for routine situations that we know are going to occur. In your example its like telling the car insurer, “I am going to get into 2 or 3 fender benders this year”. Its really health maintenance. Old age is a pre-existing condition which will, no doubt about it, have costly ramifications for the insured or the insurer. That is why the government had to pass Medicare; insurers don’t want to pay out and as we age payouts become more likely. So the Feds had to step in or we would have a bunch of sick and dieing indigent elderly; that is bad for our image as the beacon of freedom and opportunity.
The second fallacy is that the typical model of capitalism is at work in health care. Buyer and seller negotiate in a typical capitalistic transaction; last time I thought about it there is no negotiation with the Doc while someone is having a heart attack, stroke or head trauma. You aren’t shopping it around.
The one mandate I would have like to see is that insurers would have been required to accept a percentage (based on their total customer base) of the pool of high risk or high cost customers at mandated rates if they wanted to do business in the U.S. Doesn’t preclude them from having add-on parts of their health programs with un-regulated cost structures. This is not in the bill; we the taxpayers are picking up the bill on the high risk pool.
· Flag
The thing that really pissed me off, was the Republican argument that Elected officals would be making the decision on what care is covered, and that market forces should control costs. Obviously they never had to buy health insurance. I would rather have elected officials or even an apointed official run the health care system then some CEO who only cares about profits and their million dollar plus salaries. The Republicans obviously never had to deal with a procedure being turned down or a medication being turned down (that wasn’t elective). The “marketdriven” costs has my policy as 1200.00 a month. It has gone up every year. Luckily I have not had the 40% increases.
· Flag
My partner died recently and I want to move back to San Francisco. I have HIV and a couple of other pre-existing conditions. Does anyone know if the new high risk pool will cover people who make more than the poverty level and does this insurance cover the HIV meds well or are there 50% copays or such
· Flag
The reason you queers have HIV/Aids, is because you enjoy taking it up the chute. The man upstairs realizes you are misfits and not worth a squirt of piss, and is attempting to kill you off.
You all disgust me. This marriage garbage will make it as far as the Supreme Court, and then you’ll be F’ed.
· Flag
Brett … ah yes once again you prove how the truly chicken-shoot people can hide behind nick names and shoot off hateful and bigoted comments.
May God bless you without any deiseases from feeding your mouth hole with bad food, too much drink, or exposing you to too many chemicals. All of these things you may not know about at the time, but hopefully will make you sick without health insurance and give you a sample of what we go through.
· Flag
BRETT…
I THINK YOU ARE NOT KNOWLEDGEABLE ABOUT THE HIV/AIDS, ITS PEOPLE LIKE YOU WHO MAKE IT DIFFICULT FOR EVERYONE ELSE. MY MOTHER DIED FROM AIDS BECAUSE PEOPLE LIKE YOU DON’T KNOW THEY HAVE IT AND GIVE BLOOD. BACK IN THE DAY DOCTORS DID NOT TEST FOR THIS. THAN WHAT IF WOMEN FOR EXAMPLE LIKE YOUR WIFE GOT ” IT UP THE CHUTE” AS YOU SAY THAN YOU HAD SEX WITH HER NOW YOU HAVE IT. SO I GUESS YOU BOTH DESERVE TO DIE CAUSE “THE MAN UP STAIRS” SAYS ACCORDING TO YOU ARE “are misfits and not worth a squirt of piss, and is attempting to kill you off.THINK ABOUT WHAT YOU ARE SAYING YOU DON’T KNOW WHERE SHE HAS BEEN OR WHO THOSE PEOPLE SHE WAS WITH HAVE BEEN WITH.You disgust me.
· Flag
I’m reading all of this with an objective mind and lordy I am just repulsed by all this venom and disgusting hatred being spewed out here on this subject.
No, I mean seriously now. We’re supposed to be adult thinking people and the tone of this discussion is HORRENDOUS! Why does the issue of health care for people with life threatening and chronic illness always CRASH into what amounts to “Yeah, but my Dad is bigger than your dad and my dog is meaner than yours…….”
Oh, my, Lord…….
Any amount of people with perceived “grudges” against another class of peoples can dredge up the same old tired arguments against the right of any human being to remain alive like the rest of “Healthy America” but egads people….
What purpose does that sort of thing serve? To vent? To prove you are more right than another? To defend yourself somehow? To puff out your chest and think: “Well I showed HIM/HER!!!!”
I’m not taking the Rodney King line of “Can’t we all just get along?” because I’m not naive enough to think that we will EVER do so. We’re unique individuals and we come from unique backgrounds….
The bottom line is simply this: At any given moment in your life and no matter how extreme you may feel RIGHT AT THIS MOMENT in your life?
God or whoever is your higher power can reduce you to a mere puddle of mud on a sidewalk when what you thought you believed is challenged by a very life threatening challenge to your OWN future on this earth as a human being.
And there will be people just like the you you are now arguing against your right to exist with a chronic terminal illness that requires meds that you have to take just to STAY ALIVE.
Think about that……
You would be well to sit back, take a deep breath and contemplate the fact that when you were born, there was no “Warranty” that guarantees you 120 years of healthy LIFE.
· Flag
for the first time since i was diagnosed with hiv in 2004, i am scared for my well being. In a nutshell, here is my ocncern. My employer of less than 25 employees, eliminated the group policy for covered employees. I went to the SAME carrier for a conversion policy and i got the shock of my life…..premiums are 450% higher than premiums that both employer and employee paid. this specifically is due to my condition; pre-exsisting. These insurance companies S/B ashamed of themselves.
I’ll have to wait till januray 2014 for coverage i guess.
· Flag
I know a place where you can get very cheap HIV medicine for 30-40% off the market price i have hiv and i take tenofovir they cost aroun $900 for a 30days usage. When i found the source i paid 400 for a 30days supply. if anyone interested in where i got it from email me at alvp0box@me.com
· Flag
I would have thought that anyone with HIV or AIDS who could not afford the treatment and therefore did not get any meds would be dead by now.