You probably know that HIV medications are very expensive. How does the average person pay for them?
The answer is that there are lots of resources available to help you pay for your treatment and medications. The poorer you are, the more help is available to you. So don’t panic! You’re going to be fine.
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But, getting the assistance you need can be complicated. So, if you’ve just been diagnosed with HIV, the first thing you should do is visit your nearest ASO (AIDS Service Organization), introduce yourself, and ask for help. A list of ASOs in every state can be found on-line at: ASO Listings. Or, your state HIV/AIDS hotline should be able to give you the name and address of an ASO near you.
If you’re going to need a lot of help for a long period of time, an ASO may assign you a “case manager.” (Some ASOs assign all their clients a case manager.) If you’re coping well on your own but need a little help with specific problems, you may work with a “benefits counselor.” A good case manager or benefits counselor can be a real financial life-saver! All the things that seem so frustrating to you are just “part of the job” to them. They know how to fill out the forms. They know who to call. They know the difference between how a program is supposed to work and how it really works. Finding a good one will make your life a lot easier!
Here are some of the options available to you for paying for your HIV care:
The first option for paying for your HIV-related health care and medicine is health insurance. Unfortunately, very few people have insurance that covers both HIV and their HIV prescriptions. Many companies today are “self-insured,” and those companies may exclude certain expensive disorders from coverage – including HIV. Also, although your health insurance may cover HIV treatment, it may limit coverage for prescription drugs, which will be by far your biggest expense.
If you have good insurance, consider yourself fortunate. Paying your co-payments and deductibles may take a chunk out of your income. But with health insurance paying the lion’s share of your medical costs, you can keep working, moving up the career ladder, saving for retirement and building your future.
If not, you have other options.
If you do not have prescription coverage and your income is relatively low, you may be able to get help paying for your medications through ADAP – the “AIDS Drug Assistance Program.” ADAP is a federal program, established as part of the Ryan White CARE Act. But it is administered by the states, and funded by both the federal government and the states. The drugs the program covers vary WIDELY from state-to-state, and so does the amount of money you can earn and still qualify for help! Because ADAP is so important, and varies so much from state to state, we have devoted most of this Financial Guide to a listing of the ADAP formularies and qualifications for each state.
Unfortunately, ADAP programs in many states are seriously underfunded right now, leading to waiting lists in many states. Many people who should be getting their drugs from ADAP have been forced to get them from the drug companies’ patient assistance programs instead.
Disability and Medicaid