Getting HIV Drugs in the U.S.
October 26, 2014
Table of Contents
Health insurance covers some of the cost of prescription drugs, including HIV drugs. The best way to get health insurance is to work for an employer who provides it. Some employers, especially small businesses, do not offer health insurance. If you do not work, or your employer does not offer health coverage, check to see if you qualify for any public health insurance programs (see below). If you do not, you may be able to buy an individual insurance plan directly from an insurance carrier.
Most insurance plans include some drug coverage. However, co-pays add up. Some people choose to get their medicines from mail-order pharmacies. Mail-order pharmacies can have benefits like lower co-pays and home delivery of medications. However, it is important to realize that mail-order pharmacies -- like local pharmacies -- can make mistakes. When they do, it can take some time for the correction to be made. For example, sometimes a mail-order pharmacy may send one part of your HIV drug regimen and forget to send the other part. By the time the mail-order pharmacy sends the missing drug, you may have run out of your complete regimen. Also, if you just received a three-month supply of one HIV drug in the mail and you need to change HIV drugs, you may have difficulty getting insurance to cover the new drug until you have used up the old one.
You may want to speak to your insurance carrier and your health care provider about using a mail-order pharmacy to see if it is a good option for you.
The Affordable Care Act (ACA) was signed into law by President Obama in 2010. The ACA provides for several changes that can dramatically improve the health of people living with HIV (HIV+) by increasing their access to health care. For example, it stops insurers from denying coverage to those with pre-existing conditions (like HIV or pregnancy) and stops insurers from putting lifetime or annual spending limits on insurance benefits, which often affect those living with long-term conditions like HIV.
The ACA creates health insurance marketplaces for people to buy affordable health insurance if they do not have access to employer-based programs. It also provides for changes to many programs that already help HIV+ people get their HIV drugs, like Medicaid and Medicare. For more information, read about each of the specific programs below and see The Well Project's article, The Affordable Care Act and Women in the US.
The AIDS Drug Assistance Program (ADAP) is funded by the federal government to help pay for HIV drugs for people who might not be able to afford them otherwise. Your local ADAP office can let you know which drugs it pays for and what the income limits are for your state.
Some states have a waiting list for ADAP. In other states, the ADAP program is big enough to cover not only HIV drugs, but also some medical care and non-HIV medications, such as those used to manage side effects.
This article was provided by The Well Project. Visit The Well Project's Web site to learn more about their resources and initiatives for women living with HIV. The Well Project shares its content with TheBody.com to ensure all people have access to the highest quality treatment information available. The Well Project receives no advertising revenue from TheBody.com or the advertisers on this site. No advertiser on this site has any editorial input into The Well Project's content.
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