From Positive Times: How to Get Help with Health Insurance and Benefits Questions

By Cindy Wallace, LCSW


Fall is the perfect time to be reviewing your current insurance coverage as well as thinking about your future coverage needs. Many employers offer the opportunity to make changes in the fall; there are open enrollments for Affordable Care Act Marketplace Plans, as well as Medicare prescription drug plans (Part D) and Medicare HMO plans (Part C). However, understanding and navigating the world of insurance is easier said than done! Working through insurance options is certainly complex, often frustrating and can lead to more questions than answers.

The UW Health HIV Clinic has a dedicated team of social workers who are experts on insurance, resources and benefits. Our social workers have years of collective experience in exploring insurance options, assessing your individual situation and ensuring you have the most up-to-date information – allowing you to make informed decisions about your coverage. Additionally, they can provide practical support and help you sign up for insurance, the Wisconsin insurance premium assistance program and other benefits, as well as provide any necessary advocacy to help you access what you need.

Everyone receiving care in our clinic can meet privately with a social worker to discuss available insurance and benefit programs. Common questions include:

  • Can I keep my provider if my insurance changes?
  • When can I sign up for insurance or change my insurance plan?
  • What if my insurance doesn’t cover all of my office and medication costs? Is there any help?
  • What is the difference between a copay and co-insurance?
  • I’m losing coverage and won’t be able to pay for my meds. What is going to happen?

You can easily reach one of our social workers by simply calling our clinic at (608) 263-0946. The person answering the phone will take your name and phone number and will have one of our social workers call you back within 1-2 business days.

In future newsletters, we will be highlighting specific types of insurance and benefit programs that can help PLWH continue to prioritize their health. Stay tuned for information on our Ryan White Program, the Affordable Care Act, AIDS Drug and Premium Assistance Programs (ADAP) and other related topics!