HIV Meds Covered Under Insurance?

[PozBearWI]

3 hours ago, Pozzible said:

Well, under Biden a law was enacted that capped the yearly total cost of drugs for Part D participants at $2000 for the entire year. It was terrific! I believe I was told that the cap will be about &2200. Which is still great! I think that’s for all enrolled in Part,D supplement plans. Medicare Advantage is a whole different animal.

But essentially part D (drug plan) is the same for both advantage and supplement

[Pozzible]

I’ve never considered Medicare Advantage. I thought prescription drug coverage was just a fully integrated part of that program (Part C)?

[descartes70817]

I had BCBS medical insurance when I was first diagnosed with full blown AIDS in 2017, but I have never had to pay anything for my HIV meds - not even when I was laid off and dependent on COBRA.

When my COBRA expired and before I was assessed as disabled the clinic I use applied for HIV meds from the manufacturer on my behalf, and they gave me (up to) 12 months of meds for free until my SSDI and MEDICARE kicked in.

I still haven't had to pay for HIV meds in the 9 years since I was diagnosed. The clinic I use is a Ryan White affiliate so that might be why I've never had to pay anything.

Edited Monday at 05:25 PM by descartes70817

[descartes70817]

5 hours ago, descartes70817 said:

I had BCBS medical insurance when I was first diagnosed with full blown AIDS in 2017, but I have never had to pay anything for my HIV meds - not even when I was laid off and dependent on COBRA.

When my COBRA expired and before I was assessed as disabled the clinic I use applied for HIV meds from the manufacturer on my behalf, and they gave me (up to) 12 months of meds for free until my SSDI and MEDICARE kicked in.

I still haven't had to pay for HIV meds in the 9 years since I was diagnosed. The clinic I use is a Ryan White affiliate so that might be why I've never had to pay anything.

I should have added that through the clinic I have had a secondary insurance from a state funded healthcare access plan since 2022, but even before then I was never billed for my HIV meds

[Josh1959]

14 hours ago, descartes70817 said:

I had BCBS medical insurance when I was first diagnosed with full blown AIDS in 2017, but I have never had to pay anything for my HIV meds - not even when I was laid off and dependent on COBRA.

When my COBRA expired and before I was assessed as disabled the clinic I use applied for HIV meds from the manufacturer on my behalf, and they gave me (up to) 12 months of meds for free until my SSDI and MEDICARE kicked in.

I still haven't had to pay for HIV meds in the 9 years since I was diagnosed. The clinic I use is a Ryan White affiliate so that might be why I've never had to pay anything.

Believe it or not, most drug companies exclude government insurance. I called Eli Lilly to apply for a coupon to help with the copay ( which they did for years when I was on corporate insurance), but even my social security put me over the minimum income level.

[Hungryforbbc]

15 minutes ago, Josh1959 said:

Believe it or not, most drug companies exclude government insurance. I called Eli Lilly to apply for a coupon to help with the copay ( which they did for years when I was on corporate insurance), but even my social security put me over the minimum income level.

Yeah I got that coupon last year it actually met my deductible for my corporate insurance - now im on medicaid and im hoping it won’t be a problem when I go to get it refilled 

[Josh1959]

Just now, Hungryforbbc said:

Yeah I got that coupon last year it actually met my deductible for my corporate insurance - now im on medicaid and im hoping it won’t be a problem when I go to get it refilled 

My experience was it immediately stopped when Medicare replaced my corporate insurance. Best of luck to you.

[PozPumpDump]

Yes, I'm on Biktarvy, its covered by most health insurance plans (commercial, Medicare, Medicaid, VA/TRICARE), but costs vary, manufacturer copay cards and patient assistance programs (like Ryan White Program) can lower costs to $0-$5 monthly for eligible patients.