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Health Insurance Premiums Unaffordable
Oct 26, 2012

HI, I work for a County in Southern California that pays a portion of my medical(about $200), but our portion is increasing from about $230/mo to about $530/month. The County will not allow us to cancel our medical insurance without proof of medical insurance elsewhere. I work full time, am HIV+, earn over 300% of the Fed. Poverty Level, but my net I can barely survive off of let alone paying $530/mo for Medical. I earn about $39K gross and $23K net. I feel like those who work are penalized for working and do not qualify for Ryan White, OA-HIPP, HIPP, MMRP, etc. I can't get a individual plan because of a pre-existing condition. I am at my wits end and would like to qualify for a premium assistance program or buy an individual plan that allows pre-existing conditions and then I can cancel that and try to get on Ryan White. Any suggestions? I've already reduced my expenses as much as I can!

Response from Mr. Chambers

You have asked a difficult question, although it would have an easy answer if we were in almost any other industrialized country who all have some form of single payor health care.

You are correct that OA-HIPP is not available to persons whose employers are paying even just a portion of the premium. HIPP is a Medi-Cal program which you don't qualify for since you are working. MMRP I'm not sure of. Do you mean MRMIP, California's High Risk Health Pool? If so, it's premiums are higher than what you pay and the coverage is substantially less.

Bottom line after all that, I really don't have any alternatives for you right now. I am surprised your employer won't let you opt out of coverage without proof of other coverage. Double check that with your bargaining unit if you are part of one.

Of course, even if you could opt out, I have no alternative coverage for you. There is a Pre-Existing Conditions Insurance Plan (PCIP) but you have to be without any health insurance for six months to be eligible.

If you can hang on for another year, you will be able to buy individual coverage beginning January 1, 2014. Although there are provisions in the law that are aimed at controlling costs, the premiums that will be charged under the new law are not yet known, so it's impossible to say how "affordable" they will be.

I'm sorry I know of no premium assistance plans that will help you currently. And I don't know of any reputable plans that will cover you as an individual right now.

Far fetched answers include finding another job; find a partner or spouse whose plan would cover you. Not really good options.

I hope you are taking advantage of AIDS Drug Assistance Program (ADAP) to at least pick up the copays of many medications. If not, you can get more information on that at a local AIDS Service Organization.

I'm sorry I don't have a good solution to your problem.

Good luck, Jacques

Medicare Plans?
HIV+ Pharmacy Tech student externing at hospital

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