World AIDS Day 2020, Ending the HIV/AIDS Epidemic: Resilience and Impact
Learn more about self-testing for HIV.
See if you qualify for Ready, Set, PrEP.
Learn more about the importance of viral supression.
HIV care and treatment involves taking antiretroviral therapy (ART) and having regular check-ups with your healthcare provider who will monitor your health status on an ongoing basis.
These things are important because with the proper care and treatment, you can reduce your viral load, protect your health, enjoy a long and healthy life, and reduce the potential of transmitting the virus to others.
But you might have concerns about how to pay for this. There are resources that can help you pay for the care you need.
Job-Based and Individual Insurance—Many people have private health insurance through their employer (or a family member’s employer), or they have individual insurance they have purchased. Under the Affordable Care Act (ACA), most job-based and individual plans are required to offer new benefits and protections. For example, plans can’t can drop you or deny you coverage just because you have a pre-existing health condition, like HIV. And insurers can’t impose lifetime caps on your insurance benefits. However, you’ll still need to pay any deductibles, copayments, and coinsurance your plan requires. Make sure you read your plan carefully so that you know what your plan will (and won’t) cover.
When you leave a job, you may be able to keep your job-based health insurance for a period, usually up to 18 months. This is called COBRA continuation coverage. With COBRA coverage, you usually have to pay the entire monthly premium yourself, plus a small administrative fee. Your former employer no longer pays any of your insurance costs.
The Health Insurance Marketplace—Established under the ACA, the Health Insurance Marketplace helps uninsured people find and apply for quality, affordable health coverage. Private plans in the Marketplace are required to cover a set of essential health benefits. And, low and middle-income people may qualify for lower costs, based on their household size and income. To see if you can enroll in a health insurance plan or change plans, visit healthcare.gov or find local help.
The Marketplace Open Enrollment Period is November 1, 2020 – December 15, 2020, for coverage beginning January 1, 2021
If you do not have private health insurance—or you need help because your insurance doesn’t pay for the HIV care and treatment you need—there are Federal resources that may help you.
Getting Help—Figuring out which programs and services you qualify for can be confusing. But don’t worry! There are case managers and benefits counselors who can help you. They know what services are available and can help you get care. Their services are free. You can find one near you by contacting a local HIV/AIDS service organization. Toll-free State HIV/AIDS Hotlines will help put you in touch with agencies that can determine what programs and services you may be eligible for and help you access them.
Here are Federal resources that are available:
The Medicare Open Enrollment Period is October 15, 2020 - December 7, 2020, for coverage beginning January 1, 2021.
Patient Assistance Programs (PAPs) are programs administered by pharmaceutical companies to offer free or reduced-cost antiretroviral (ARV) medicines to low-income people living with HIV who are uninsured or underinsured, and who do not qualify for assistance programs such as Medicaid, Medicare, or AIDS Drug Assistance Programs. Each pharmaceutical company has different eligibility criteria for qualifying for their PAP.
The U.S. Department of Health and Human Services, seven pharmaceutical companies, the National Alliance of State and Territorial AIDS Directors (NASTAD), and community stakeholders worked together to develop a common patient assistance program application (CPAPA) and companion document that can be used by patients and providers to access these programs.