Paying for Care
If you are uninsured or having trouble with out-of-pocket costs related to your care, please contact your social worker/medical case manager:
One of the most critical barriers for people living with HIV face in accessing care is the cost of medical care and medications. The complexity of obtaining public benefits and/or private insurance may deter some patients from accessing ongoing healthcare.
The UW Health HIV/AIDS Comprehensive Care Program has funding to assist uninsured and underinsured patients to access care. Our social workers, also referred to as medical case managers (MCMs), are trained to screen for eligibility and help you enroll in benefit programs on-site while you are at the clinic to ease frustration and better ensure continuity of services.
Your social worker will check your eligibility for employer-sponsored insurance, university/college-sponsored insurance, ACA marketplace (Obamacare) insurance plans and subsidies, Medicaid, Medicare and VA benefits. The social worker will also screen for eligibility for Ryan White-funded services and/or the AIDS Drug Assistance Program (ADAP).
If you meet eligibility requirements for any of these programs, a social worker will help you apply for and secure benefits. This includes assistance with initiating Social Security disability claims when needed.
The social worker continues to work with you throughout the course of care to identity other means for healthcare coverage and completes regular Ryan White and ADAP re-certifications.
In addition to helping patients secure health insurance, social workers may also help you apply for copay assistance programs, Food Share, Energy Assistance, Department of Workforce Development programs/benefits, and provide referrals for housing and rental assistance.
Medicaid, BadgerCare Plus and the Medicaid Purchase Plan coverage provides access to most aspects of HIV care; however, there are two gaps in coverage that affect people living with HIV. Many people lack coverage for over-the-counter medications, such as vitamin D supplements, and prior authorization requirements that restrict Hepatitis C treatment and other therapies. The UW Health HIV/AIDS Comprehensive Care Program provides assistance to cover these gaps.
Medicare and insurance plans provide coverage for most HIV-related care; however, out-of-pocket deductibles and coinsurance costs can be challenging for some. In addition, the Medicare Part D coverage gap for medication costs is another burden for some patients, which can affect their access to needed medications. The UW Health HIV/AIDS Comprehensive Care Program can provide assistance to help with these costs. Even if you are able to afford medication copyas, you may be eligible to reduce your out-of-pocket medication expenses through manufacturer copay card programs. Our social workers are available to help you get connected to this important resource.
As a Ryan White-funded program, the UW Health HIV/AIDS Comprehensive Care Program will never deny you access to care due to inability to pay. If you are worried about costs, please speak to your social worker.