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Paying for everyday needs and health care is hard for many people, including those living with HIV/AIDS. HIV/AIDS drugs are expensive, and many people find it hard to buy the medicines they need. Some people with HIV/AIDS are not able to work. Other people may have problems getting the housing they need. Studies show that people with HIV/AIDS are better able to take care of their health when all their basic needs, like housing, are met. Services are available to help people with HIV/AIDS pay for health care, medicine, housing, and other basic needs.
Many people who are infected with HIV are able to live full lives with no signs of their infection for a long time. The main way these people will be paying for HIV care is with health insurance. Even when you seem to be doing fine with HIV, you will have expenses. At first you may need screenings and doctor visits, but eventually you will need expensive medicine and other care.
Today, most Americans living with HIV get their insurance from Medicaid or Medicare. These are government-run insurance programs. Medicare is for people over 65 and people with disabilities. Medicaid is for people with low incomes and people with disabilities. Some people get health insurance through their employer. There are also people who have to buy plans on their own. This might include people working for small businesses that don't offer insurance. Getting coverage has been difficult for people living with HIV/AIDS. Nearly 30 percent of people with HIV don't have any insurance at all. People with HIV can also get assistance from the AIDS Drug Assistance Program (PDF, 93 KB). This program helps people who cannot afford to pay for their HIV medications.
In addition to Medicare and Medicaid, other health insurance is changing because of health care reform. Learn more about how to get the health insurance you need at HealthCare.gov.
The Health Insurance Portability and Accountability Act of 1996 (HIPAA) helps people with HIV/AIDS keep their health insurance. Part of the law protects people when they lose or change jobs by offering insurance "portability" to qualifying people. The law also sets guidelines to keep people's medical information private.
If you have HIV/AIDS and cannot work, you may qualify for help from the Social Security Administration. The money you get can help you pay for basic needs, such as food, clothing, and shelter. Benefits are paid under two programs:
If your Social Security benefits are very low and you have limited other income and resources, you may qualify for both programs.
Special rules make it possible for people with disabilities receiving Social Security benefits or Supplemental Security Income (SSI) to work and still receive monthly payments and Medicare or Medicaid. Social Security calls these rules work incentives. Contact your state Social Security office to find out if you can make use of these programs.
Medicaid is a federally-sponsored health program for people with low income. Each state runs its own Medicaid program. Medicaid does not pay money to you; instead, it sends payments directly to your doctors. You must qualify to get Medicaid. Most adults with HIV who qualify for Medicaid:
Medicaid was expanded under health care reform. So if you haven't qualified before, you might now. You apply to Medicaid in the state where you live. Each state has different rules as to whether you qualify. You can get an application at your local Medicaid office. You can also call your local Social Security office. Learn more from the Centers for Medicare and Medicaid Services.
This federal program helps people with HIV/AIDS who have nowhere else to turn for the care they need. It pays for doctor visits, HIV/AIDS drugs, and supportive services for people with HIV/AIDS. In some cases, family members can receive services through a Ryan White program for women, infants, children, and youth, even though they are not diagnosed with HIV. Call your state's HIV/AIDS hotline to ask about care or medicines through Ryan White or other programs.
You can get help paying for HIV/AIDS drug treatment:
If you get your medications through Medicare Part D coverage, health care reform may make drugs more affordable for you. People whose HIV drugs are paid for with Medicare Part D may fall into the "donut hole" in drug coverage. This means that the costs are high enough that Medicare stops paying for them, and you pay the rest. When your drug costs increase much more in the same year, a type of emergency coverage kicks in, and Medicare pays for your drugs again. For people paying for all of their drugs while in this "donut hole," health care reform now gives them a 50 percent discount on brand-name drugs. More discounts will go into effect in coming years.
The U.S. Department of Housing and Urban Development (HUD), Office of HIV/AIDS Housing runs the Housing Opportunities for Persons With AIDS (HOPWA) program. Their programs provide HIV/AIDS housing that includes short- and long-term rental assistance, live-in medical facilities, and housing sites developed just for people living with AIDS.
Content last updated: July 01, 2011.