I'm trying to figure out when I can afford to retire. Currently, I have very good health insurance that covers most of the cost of my meds.
Does Medicare cover HIV medications and do you know roughly what I would have to pay for Atripla?
I am currently undetectable and do not want to retire unless I'm sure I can afford to keep up my medications.
Drug coverage under Medicare comes under Part D, which are separate insurance policies sold by private companies. The federal law requires all such plans to cover essentially all HIV medications.
However, Part D plans do not pay 100% of the bill. Depending on the plan, there are deductibles, then the plan covers 75% of medications. After a certain level, they only cover about half the cost (in the shrinking "donut hole"). After that, you reach Catastrophic Level where there is only a small co-pay.
You should also check with your state's AIDS Drug Assistance Program (ADAP) Depending on your income and what state you live in, the ADAP program may cover what Part D does not for drugs that are on the ADAP formulary. In some states, ADAP will also pay the Part D premium, although low income people may also qualify for Medicare's Low Income Subsidy or Extra Help which will pay most or all of the premium with only a small copay for the medications.