Getting HIV Drugs

Table of Contents

• Health Insurance
• AIDS Drugs Assistance Program
• Medicare
• Drug Company Programs
• Clinical Trials
• Buyers' Club
• Seeking Help

Health Insurance

Health insurance usually covers most 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's 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 3-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.

AIDS Drugs Assistance Program

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.

Medicaid

Medicaid is a government-sponsored insurance program that covers healthcare and medications. If you are disabled, not working, or earning little money, you may qualify for Medicaid. Like ADAP, each state has its own program so you will need to talk to a local Medicaid worker in order to apply.

Medicare

Medicare is a government-sponsored insurance program for people over 65 and those who are disabled (with a work history) or blind. Part D of Medicare pays for medications.

For more information on ADAPs, Medicaid, and Medicare, see the Health Benefits section of our Public Benefits and HIV info sheet.